Individual provider Active NPI

Tamalyn Bayless, PHYSICAL THERAPIST

  • Physical Therapist
  • Saratoga Springs, UT
National Provider Identifier
1114635430
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4726568-2401 Issued in UT
Practice address
2421 S Maverick Rd
Saratoga Springs, UT 84045-6405
Phone
(801) 860-3219
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4726568-2401 UT Primary

Addresses

Primary practice location

2421 S Maverick Rd
Saratoga Springs, UT 84045-6405

Mailing address

2421 S Maverick Rd
Saratoga Springs, UT 84045-6405
Phone (801) 860-3219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525001930 UT Practitioner - Physical Therapist in Private Practice 1355707803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4726568-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Apr 12, 2023 Accepting new patients
Adaptive Rehabilitation Clinics, LLC Physical Therapist Past Accepting new patients

Locations

1430 E 4500 S
Millcreek, UT 84117
Phone (801) 272-8000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1114635430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 S MAVERICK RD",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840456405",
            "telephone_number": "801-860-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 S MAVERICK RD",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840456405",
            "telephone_number": "801-860-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLESS",
        "first_name": "TAMALYN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "4726568-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.