Individual provider Active NPI

Jeremy B Radmall, OTR/L

  • Occupational Therapist
  • Farr West, UT
National Provider Identifier
1164308128
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106004410-4201 Issued in UT
Practice address
2850 N 2000 W Ste 107
Farr West, UT 84404-9230
Phone
(801) 689-2389
Fax
(801) 689-3215
NPI assigned
Aug 14, 2025
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 106004410-4201 UT Primary

Addresses

Primary practice location

2850 N 2000 W Ste 107
Farr West, UT 84404-9230

Mailing address

1992 W Antelope Dr Ste 1D
Layton, UT 84041-4974
Phone (801) 689-2389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250830000511 UT Practitioner - Occupational Therapist in Private Practice 3072014067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 W 300
Logan, UT 84321-3809
Phone (435) 716-8535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106004410-4201UTMDOccupational Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1164308128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 W ANTELOPE DR STE 1D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414974",
            "telephone_number": "801-689-2389",
            "fax_number": "801-689-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 N 2000 W STE 107",
            "city": "FARR WEST",
            "state": "UT",
            "postal_code": "844049230",
            "telephone_number": "801-689-2389",
            "fax_number": "801-689-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADMALL",
        "first_name": "JEREMY",
        "middle_name": "B",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "106004410-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farr West, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.