Kevin Church Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

KEVIN CHURCH PHYSICAL THERAPY PC

Practice address

5255 S 4015 W
Suite 205
Taylorsville, UT 84118-4257

Phone

(801) 957-1797

Fax

(801) 957-1941

NPI assigned

Feb 23, 2011

Organization subpart

No

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

Authorized official

Name

Kevin D Church, P.T.NPI 1376678334

Title

Owner/Director

Phone

(801) 957-1797

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.

• Kevin Dee Church, P.T.

  • Physical Therapist
  • Taylorsville, UT
  • NPI 1376678334
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1194022418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 S 4015 W",
            "address_2": "SUITE 205",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841184257",
            "telephone_number": "801-957-1797",
            "fax_number": "801-957-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 S 4015 W",
            "address_2": "SUITE 205",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841184257",
            "telephone_number": "801-957-1797",
            "fax_number": "801-957-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN CHURCH PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "801-957-1797",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Taylorsville, UT
• Providers in Taylorsville, 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 Feb 23, 2011; 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.