NPIMap

Individual provider Active NPI

Brent F Taylor, DPT

  • Physical Therapist
  • Bountiful, UT
National Provider Identifier
1215076682
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
66741782401 Issued in UT
Practice address
3413 S 100 W
Bountiful, UT 84010-6639
Phone
(801) 292-3407
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00008334 WA
Clinical Electrophysiology Physical Therapist 2251E1300X PT00008334 WA
Physical Therapist 225100000X 66741782401 UT Primary
Clinical Electrophysiology Physical Therapist 2251E1300X

Addresses

Primary practice location

3413 S 100 W
Bountiful, UT 84010-6639

Mailing address

3413 S 100 W
Bountiful, UT 84010-6639
Phone (801) 292-3407

Other identifiers 1

IdentifierTypeStateIssuer
8407074MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515001771 TX Practitioner - Physical Therapist in Private Practice 3971532367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
66741782401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kayenta Alternative Rural Hospital CurrentSince Aug 29, 2023 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Aug 29, 2023 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Aug 29, 2023 Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients
Achieve Rehabilitation, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 5

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1215076682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 S 100 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106639",
            "telephone_number": "801-292-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 S 100 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106639",
            "telephone_number": "801-292-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRENT",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008334",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "WA",
            "license": "PT00008334",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "66741782401",
            "primary": true
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8407074",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.