NPIMap

Individual provider Active NPI

Reymund Maramento Serrano

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1194054445
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60116731 Issued in WA
Practice address
1952 E 7000 S Ste 100
Salt Lake City, UT 84121-6878
Phone
(801) 942-3311
Fax
(801) 942-5955
NPI assigned
Dec 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60116731 WA Primary

Addresses

Primary practice location

1952 E 7000 S Ste 100
Salt Lake City, UT 84121-6878

Mailing address

PO Box 711185
Salt Lake City, UT 84171-1185
Phone (801) 942-3311

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60116731WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brighton Rehabilitation LLC Physical Therapist Past Accepting new patients
Brighton Rehabilitation Agency LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1194054445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841711185",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 E 7000 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216878",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "REYMUND",
        "middle_name": "MARAMENTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60116731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.