NPIMap

Organization Active NPI

Advanced Motion Physical Therapy Inc

  • Physical Therapist
  • Magna, UT
National Provider Identifier
1255347654
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5165580-2401 Issued in UT
Legal business name
ADVANCED MOTION PHYSICAL THERAPY INC
Practice address
3665 S 8400 W
Suite 210
Magna, UT 84044-2214
Phone
(801) 250-6733
Fax
(801) 250-5038
NPI assigned
Jul 31, 2006
Last updated
Mar 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Robert Lance Dougher, PTNPI 1669458220
Title
Owner, PT
Phone
(801) 628-1924

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5165580-2401 UT Primary

Addresses

Primary practice location

3665 S 8400 W
Suite 210
Magna, UT 84044-2214

Mailing address

3665 S 8400 W
Suite 210
Magna, UT 84044-2214
Phone (801) 250-6733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050810000329 UT Part B Supplier - Clinic/Group Practice 2769411743 Receives reassigned benefits from 7 practitioners
Practice locations: Bluffdale, UT; Magna, UT

National Provider Directory

National Provider Directory

Locations

14572 S 790 W
Ste B
Bluffdale, UT 84065
Phone (801) 571-3030

3665 S 8400 W
Ste 210
Magna, UT 84044
Phone (801) 250-6733

8089 W 3500 S
Magna, UT 84044

Practitioners & affiliated clinicians

Practitioners 10

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1255347654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 S 8400 W",
            "address_2": "SUITE 210",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840442214",
            "telephone_number": "801-250-6733",
            "fax_number": "801-250-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 S 8400 W",
            "address_2": "SUITE 210",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840442214",
            "telephone_number": "801-250-6733",
            "fax_number": "801-250-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MOTION PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "DOUGHER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "801-628-1924",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "5165580-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magna, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.