Pack Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PACK PHYSICAL THERAPY, INC.

Doing business as

ImPackt Physical Therapy and Sports Recovery

Practice address

11531 S District Dr Ste 900
South Jordan, UT 84095-5780

Phone

(949) 350-6370

NPI assigned

Mar 2, 2012

Last updated

Jan 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brodie James Pack, MPTNPI 1871578203

Title

President/Physical Therapist

Phone

(801) 260-3100

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• ImPackt Physical Therapy and Sports Recovery Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 22

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.

• Brodie James Pack, MPT

  • Physical Therapist
  • South Jordan, UT
  • NPI 1871578203
  Medicare reassignment Care Compare group Authorized official
• Matthew Jerry Hobbs, DPT

  • Physical Therapist
  • South Jordan, UT
  • NPI 1144706466
  Medicare reassignment Care Compare group NPD
• Austin Jay Nielsen, DPT

  • Orthopedic Physical Therapist
  • South Jordan, UT
  • NPI 1851940670
  Medicare reassignment NPD
• Eric Thoreson

  • Physical Therapist
  • Murray, UT
  • NPI 1699539478
  Medicare reassignment NPD (past)
• Cortney Breann Pack, LMT

  • Massage Therapist
  • South Jordan, UT
  • NPI 1790658201
  NPD
• Jesse Jacobo

  • Massage Therapist
  • Dana Point, CA
  • NPI 1710550124
  NPD
• Joseph Lee

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1306564208
  NPD
• Calvin Lee Lefebvre, MPT

  • Physical Therapist
  • Laguna Hills, CA
  • NPI 1851688071
  NPD
• Cheryl Ashlin Moore, DPT

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1740870930
  NPD
• Jeff Parkan, P.T.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Fountain Valley, CA
  • NPI 1467498139
  NPD
• Rebecca Gasca Rabaja, PT, DPT

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1568939387
  NPD
• Clay A Simons

  • Physical Therapist
  • Dana Point, CA
  • NPI 1104497031
  NPD

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1336413798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11531 S DISTRICT DR STE 900",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955780",
            "telephone_number": "801-260-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11531 S DISTRICT DR STE 900",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955780",
            "telephone_number": "949-350-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACK PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "BRODIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-260-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH DEPARTMENT OF COMMERCE DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING",
            "identifier": "2774652-2401",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@impacktpt.com",
            "affiliation": "N",
            "address_1": "11531 S District Dr Ste 900",
            "city": "South Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840955780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ImPackt Physical Therapy and Sports Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Gareth Owen, MD
• McKinsey Owen, FNP-C
• Own My Health LLC (Own My Health)
• P4 Pharmacy
• Heidi Pace
• Brodie James Pack, MPT
• Cortney Breann Pack, LMT
• Cassandra Mara Padgett
• Keith Page, PHARMD
• Madison Page

• 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 Jan 21, 2025; 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.