Greater St George Physical Therapy and Wellness, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

GREATER ST GEORGE PHYSICAL THERAPY AND WELLNESS, INC.

Practice address

616 S River Rd Ste 230
St George, UT 84790-2154

Phone

(435) 429-6887

Fax

(435) 429-2838

NPI assigned

Sep 17, 2018

Organization subpart

No

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

Authorized official

Name

Tom D Benolerao, PTNPI 1922187947

Title

Owner

Phone

(435) 429-6887

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tom Benolerao, PT

  • Physical Therapist
  • Saint George, UT
  • NPI 1922187947

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1144704065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 W 1820 N",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704856",
            "telephone_number": "435-429-6887",
            "fax_number": "435-429-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 S RIVER RD STE 230",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902154",
            "telephone_number": "435-429-6887",
            "fax_number": "435-429-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ST GEORGE PHYSICAL THERAPY AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "BENOLERAO",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-429-6887",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gray
• Jordan Gray, PHARM D
• Kali Gray
• Marcie Gray
• Ryan Michael Gray, DPT
• Hayley Nicole Greco
• Jean Marcel Greco
• Hannah Greeley
• Camden Mary Green
• Michael Richard Green, M.D.

• Physical Therapy Clinic/Center in St George, UT
• Providers in St George, UT by specialty
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.