Active NPI
Brent J Godfrey, DPT
- Physical Therapist
- Murray, UT
National Provider Identifier
1124538277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7330420-2401
- Practice address
- 5770 S 250 E Ste 375
Murray, UT 84107-8170 - Phone
- (801) 314-5600
- Fax
- (801) 314-5601
- NPI assigned
- Oct 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7330420-2401 | UT | Primary |
Addresses
Primary practice location
5770 S 250 E Ste 375
Murray, UT 84107-8170
Mailing address
5770 S 250 E Ste 375
Murray, UT 84107-8170
Phone (801) 314-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7330420-2401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
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- NPI 1023843844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506988800000",
"number": "1124538277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5770 S 250 E STE 375",
"city": "MURRAY",
"state": "UT",
"postal_code": "841078170",
"telephone_number": "801-314-5600",
"fax_number": "801-314-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5770 S 250 E STE 375",
"city": "MURRAY",
"state": "UT",
"postal_code": "841078170",
"telephone_number": "801-314-5600",
"fax_number": "801-314-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODFREY",
"first_name": "BRENT",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-03",
"last_updated": "2017-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "7330420-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.