NPIMap

Organization Active NPI

Odan LLC

Doing business as Fyzical Therapy and Balance Center

  • Physical Therapy Clinic/Center
  • Spanish Fork, UT
National Provider Identifier
1194560888
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ODAN LLC
Doing business as
Fyzical Therapy and Balance Center
Practice address
325 W Center St Ste 204
Spanish Fork, UT 84660-2000
Phone
(385) 406-4006
Fax
(801) 421-1752
NPI assigned
Jun 26, 2024
Last updated
Jun 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Authorized official

Name
Benjamin Pali
Title
Owner
Phone
(801) 458-7707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

325 W Center St Ste 204
Spanish Fork, UT 84660-2000

Mailing address

325 W Center St Ste 204
Spanish Fork, UT 84660-2000
Phone (385) 406-4006

Other names 1

  • Fyzical Therapy and Balance Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240813001321 UT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2264970953 Receives reassigned benefits from 1 practitioner
Practice locations: Spanish Fork, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1194560888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W CENTER ST STE 204",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602000",
            "telephone_number": "385-406-4006",
            "fax_number": "801-421-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W CENTER ST STE 204",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602000",
            "telephone_number": "385-406-4006",
            "fax_number": "801-421-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "PALI",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-458-7707"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy and Balance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.