Individual provider Active NPI

Cordon Rabe

  • Physical Therapist
  • Bountiful, UT
National Provider Identifier
1225775240
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12844413-2401 Issued in UT
Practice address
280 N Main St
Bountiful, UT 84010-6136
Phone
(801) 397-6749
NPI assigned
May 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 12844413-2401 UT Primary

Addresses

Primary practice location

280 N Main St
Bountiful, UT 84010-6136

Mailing address

PO Box 25537
Salt Lake City, UT 84125-0537

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817004270 UT Practitioner - Physical Therapist in Private Practice 8729440003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

280 N Main St
Bountiful, UT 84010-6136
Phone (801) 397-6740

5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (801) 442-2615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12844413-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Apr 2, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 18, 2023 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Jun 18, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

280 N Main St
N Salt Lake, UT 84010
Phone (801) 270-4400

900 Round Valley Dr
Ste 1
Park City, UT 84060

5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

2000 S 900 E
Slc, UT 84105
Phone (801) 446-7786

Organizations & group practices 4

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": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1225775240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106136",
            "telephone_number": "801-397-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABE",
        "first_name": "CORDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-20",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12844413-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 9, 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.