Jeramie D Gaillard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5908308-2401 Issued in UT

Practice address

4487 Sebago Way
South Jordan, UT 84095-5690

Phone

(801) 803-9800

Fax

(888) 803-9801

NPI assigned

May 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Empowered Rehab LLC

  • Physical Therapy Clinic/Center
  • South Jordan, UT
  • NPI 1538337837
  NPD (past) Authorized official

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1326249780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4487 SEBAGO WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955690",
            "telephone_number": "801-254-9745",
            "fax_number": "888-803-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 SEBAGO WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955690",
            "telephone_number": "801-803-9800",
            "fax_number": "888-803-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILLARD",
        "first_name": "JERAMIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "5908308-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgaillard89220@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": []
}

• Scott H Frogley, CCEP
• Matthew Alton Fuller, PHARMD
• Tianna Jean Fuller, FNP, MSN
• Functional Endocrinology Clinic
• Brady Gagon
• Jarom Gabriel Gaitan, CMHC
• Nick Galli, PHD, ACMHC
• Alyssa Garcia
• Kathy Stretch Garcia, MD
• Patrick Wayne Garcia, D.C.

• Physical Therapist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.