Individual provider Active NPI

Nicholas Vollmer

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1316516446
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12319825-2401 Issued in UT
Practice address
590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone
(920) 579-3074
NPI assigned
Jun 22, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12319825-2401 UT Primary
Orthopedic Physical Therapist 2251X0800X 12319825-2401 UT

Addresses

Primary practice location

590 S Wakara Way
Salt Lake City, UT 84108-1200

Mailing address

W9341 Blewett Rd
Eldorado, WI 54932-9620
Phone (920) 579-3074

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NVOLLMER520595@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827000813 UT Practitioner - Physical Therapist in Private Practice 5799180857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Wisconsin School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2655 W 9000
West Jordan, UT 84088-8542
Phone (801) 256-6430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12319825-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 2, 2023 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Jul 2, 2023 Accepting new patients
University of Utah Healthcare CurrentSince Jun 15, 2021 Accepting new patients
University of Utah Current Accepting new patients
University of Utah CurrentSince Jun 15, 2021 Accepting new patients

Locations

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

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

2655 W 9000 S
West Jordan, UT 84088
Phone (801) 256-6343

Interoperability endpoints

  • Direct secure messaging: nvollmer520595@direct.med.utah.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1316516446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W9341 BLEWETT RD",
            "city": "ELDORADO",
            "state": "WI",
            "postal_code": "549329620",
            "telephone_number": "920-579-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "920-579-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12319825-2401",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "12319825-2401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NVOLLMER520595@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.