NPIMap

Organization Active NPI

The Dr. Dale B. Hull Foundation for Neurological Rehabilitation, Inc.

Doing business as Neuroworx

  • Neurology Physical Therapist
  • Sandy, UT
National Provider Identifier
1235321811
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
120890-2401 Issued in UT
Legal business name
THE DR. DALE B. HULL FOUNDATION FOR NEUROLOGICAL REHABILITATION, INC.
Doing business as
Neuroworx
Practice address
90 W Albion Village Way
Sandy, UT 84070-4013
Phone
(801) 619-3670
Fax
(801) 619-3679
NPI assigned
Aug 16, 2007
Last updated
Apr 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Jan Black, MSPTNPI 1568429967
Title
Director
Phone
(801) 619-3670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 120890-2401 UT Primary
Neurology Physical Therapist 2251N0400X 352686-2401 UT
Occupational Therapist 225X00000X 801-479-0601 UT

Addresses

Primary practice location

90 W Albion Village Way
Sandy, UT 84070-4013

Mailing address

90 W Albion Village Way
Sandy, UT 84070-4013
Phone (801) 619-3670

Other names 1

  • Neuroworx Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040921000124 UT Part B Supplier - Clinic/Group Practice 3173591849 Receives reassigned benefits from 18 practitioners
Practice locations: Sandy, UT

National Provider Directory

National Provider Directory

Locations

90 Albion Village Way
Sandy, UT 84070
Phone (801) 619-3670

10382 S Jordan Gtwy
South Jordan, UT 84095
Phone (801) 619-3670

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1235321811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 W ALBION VILLAGE WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704013",
            "telephone_number": "801-619-3670",
            "fax_number": "801-619-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W ALBION VILLAGE WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704013",
            "telephone_number": "801-619-3670",
            "fax_number": "801-619-3679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DR. DALE B. HULL FOUNDATION FOR NEUROLOGICAL REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-619-3670",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "UT",
            "license": "120890-2401",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "UT",
            "license": "352686-2401",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "801-479-0601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuroworx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neuroworx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.