Wasatch Physical and Rehabilitation Medicine, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

WASATCH PHYSICAL AND REHABILITATION MEDICINE, P.C.

Practice address

4403 Harrison Blvd Ste 1875
Ogden, UT 84403-3325

Phone

(801) 732-5900

Fax

(801) 732-5989

NPI assigned

Mar 4, 2008

Organization subpart

No

Name

Bradley R Melville, M.D.

Title

Owner

Phone

(801) 732-5900

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2016.

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1124298377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 1875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033325",
            "telephone_number": "801-732-5900",
            "fax_number": "801-732-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 1875",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033325",
            "telephone_number": "801-732-5900",
            "fax_number": "801-732-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH PHYSICAL AND REHABILITATION MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "MELVILLE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-732-5900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400823741000",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Randall Warren, PHARMD
• Teresa Lee Warwood, APRN
• Wasatch Advanced Dental Care LLC
• Wasatch Dental Association, P.C.
• Wasatch Dermatology, PC
• Wasatch Podiatry PLLC
• Wasatch Post-Acute Services
• Wasatch RPM LLC
• Wasatch Therapy Inc
• Hannah Washke

• All providers in Ogden, UT
• Physical Medicine & Rehabilitation Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.