NPIMap

Organization Active NPI

Thatcher Brook Outpatient Therapy LLC

  • Physical Therapy Clinic/Center
  • Clearfield, UT
National Provider Identifier
1316721285
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THATCHER BROOK OUTPATIENT THERAPY LLC
Practice address
1795 Chelemes Way
Clearfield, UT 84015-6298
Phone
(801) 614-5700
Fax
(801) 614-5750
NPI assigned
Aug 22, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Authorized official

Name
Tyler Sase, COTA/LNPI 1134317019
Title
Director of Rehabilitation
Phone
(801) 614-5700

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1795 Chelemes Way
Clearfield, UT 84015-6298

Mailing address

1795 Chelemes Way
Clearfield, UT 84015-6298
Phone (801) 614-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231025003644 UT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1850747940 Receives reassigned benefits from 7 practitioners
Practice locations: Clearfield, UT

National Provider Directory

National Provider Directory

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": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1316721285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 CHELEMES WAY",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840156298",
            "telephone_number": "801-614-5700",
            "fax_number": "801-614-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 CHELEMES WAY",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840156298",
            "telephone_number": "801-614-5700",
            "fax_number": "801-614-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THATCHER BROOK OUTPATIENT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "SASE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "DIRECTOR OF REHABILITATION",
        "authorized_official_telephone_number": "801-614-5700",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.