Individual provider Active NPI

Joshua Owen Tilley, DPT

  • Physical Therapist
  • West Valley City, UT
National Provider Identifier
1285874123
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7119397-2401 Issued in UT
Practice address
3725 W 4100 S
West Valley City, UT 84120-5530
Phone
(801) 965-3545
Fax
(801) 965-3518
NPI assigned
Mar 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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 7119397-2401 UT Primary

Addresses

Primary practice location

3725 W 4100 S
West Valley City, UT 84120-5530

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (801) 294-6907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140512001910 ID Practitioner - Physical Therapist in Private Practice 2769537174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Texas Tech University Health Science Center School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Physical Therapy P CGroup PAC ID 7012977168, 22 clinicians

Practice addresses (Care Compare)

1005 Michigan Ave
Orofino, ID 83544-9001
Phone (208) 476-9365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7119397-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Physical Therapy P C Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Paula Elrod, PT, PC Physical Therapist Past Accepting new patients
Rocky Mountain Therapy Services Texas LLC Physical Therapist Past Accepting new patients
Grantsville Physical Therapy PLLC Physical Therapist PastSince May 29, 2026 Accepting new patients

Locations

678 Southway Ave
Lewiston, ID 83501
Phone (208) 746-1418

1174 Alturas Dr
Ste 2
Moscow, ID 83843
Phone (208) 375-0666

1005 Michigan Ave
Orofino, ID 83544
Phone (208) 375-0666

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": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1285874123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205530",
            "telephone_number": "801-965-3545",
            "fax_number": "801-965-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "JOSHUA",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "7119397-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.