Active NPI
Bradley Grgurich, DPT
- Physical Therapist
- Draper, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT029354
- Practice address
- 65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096 - Phone
- (385) 308-8034
- NPI assigned
- May 1, 2012
- Last updated
- Jun 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-06940 | KS | |
| Physical Therapist | 225100000X | P20917 | NC | |
| Physical Therapist | 225100000X | 11080 | CO | |
| Physical Therapist | 225100000X | 10798 | SC | |
| Physical Therapist | 225100000X | PT029354 | PA | Primary |
| Physical Therapist | 225100000X | 048542 | NY | |
| Physical Therapist | 225100000X | 301264 | CA | |
| Physical Therapist | 225100000X | 040.0134367 | VT | |
| Physical Therapist | 225100000X | PT-2026-0161 | NM | |
| Physical Therapist | 225100000X | 13331 | CT |
Addresses
Primary practice location
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Mailing address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034
Other practice location 1
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone (385) 308-8034
Other practice location 2
805 N Richardson Ave
Roswell, NM 88201-4920
Phone (575) 622-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11080 | Other | CO | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6298 Veterans Pkwy
Suite 5a
Columbus, GA 31909-6245
Phone (706) 320-0927
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10798 | SC | MD | Internal Medicine Physician |
| 301264 | CA | MD | Physical Therapist |
| 11080 | CO | MD | Physical Therapist |
| 11-06940 | KS | MD | Physical Therapist |
| P20917 | NC | MD | Physical Therapist |
| PT-2026-0161 | NM | MD | Physical Therapist |
| 048542 | NY | MD | Physical Therapist |
| 040.0134367 | VT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Human Performance and Rehabilitation Centers, LLC | Multi-Specialty | Current | Accepting new patients |
| Sentry Home Health Care LLC | Physical Therapist | Current | Accepting new patients |
| Sentry Safety and Physical Therapy Specialists, LLC | Multi-Specialty | Current | Accepting new patients |
| Human Performance and Rehabilitation Centers LLC | Current | Accepting new patients |
Locations
6298 Veterans Pkwy
Ste 5A
Columbus, GA 31909
Phone (706) 320-0927
1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039
805 N Richardson Ave
Roswell, NM 88201
Phone (575) 622-6260
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Columbus, GA
- NPI 1104415983
Multi-Specialty
-
- Durable Medical Equipment & Medical Supplies
- Columbus, GA
- NPI 1891583654
-
- Physical Therapist
- Roswell, NM
- NPI 1619349743
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1235497918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 E WADSWORTH PARK DR STE 230",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208096",
"telephone_number": "385-308-8034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 E WADSWORTH PARK DR STE 230",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208096",
"telephone_number": "385-308-8034"
}
],
"practiceLocations": [
{
"address_1": "65 E Wadsworth Park Dr Ste 230",
"address_purpose": "LOCATION",
"city": "Draper",
"state": "UT",
"postal_code": "840208096",
"country_code": "US",
"telephone_number": "385-308-8034",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "805 N Richardson Ave",
"address_purpose": "LOCATION",
"city": "Roswell",
"state": "NM",
"postal_code": "882014920",
"country_code": "US",
"telephone_number": "575-622-6260",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRGURICH",
"first_name": "BRADLEY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-01",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-06940",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P20917",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "11080",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "10798",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT029354",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "048542",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "301264",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040.0134367",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT-2026-0161",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "13331",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "11080",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.