NPIMap

Organization Active NPI

Intermountain Healthcare

  • Physical Therapy Clinic/Center
  • Riverton, UT
National Provider Identifier
1114378288
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
9811303-8016 Issued in UT
Legal business name
INTERMOUNTAIN HEALTHCARE
Practice address
3741 W 12600 S
Riverton, UT 84065-7215
Phone
(801) 285-3400
NPI assigned
Jun 29, 2016
Last updated
Jun 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pam Dibblee, DPT
Title
DPT, Clinic Manager
Phone
(801) 285-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 9811303-8016 UT Primary

Addresses

Primary practice location

3741 W 12600 S
Riverton, UT 84065-7215

Mailing address

3741 W 12600 S
Riverton, UT 84065-7215
Phone (801) 285-3400

National Provider Directory

National Provider Directory
Tax ID family
Robert E Fowles MD485 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1114378288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657215",
            "telephone_number": "801-285-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657215",
            "telephone_number": "801-285-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "DIBBLEE",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "DPT, CLINIC MANAGER",
        "authorized_official_telephone_number": "801-285-3400",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "UT",
            "license": "9811303-8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.