Individual provider Active NPI

Carrie Lynn Cervantes, DPT

  • Physical Therapist
  • Kaysville, UT
National Provider Identifier
1346574001
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7305977-2401 Issued in UT
Practice address
335 N 300 W
103
Kaysville, UT 84037-1815
Phone
(801) 546-6868
Fax
(801) 546-8225
NPI assigned
Sep 29, 2009
Last updated
Jun 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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 7305977-2401 UT Primary

Addresses

Primary practice location

335 N 300 W
103
Kaysville, UT 84037-1815

Mailing address

335 S 300 W
103
Kaysville, UT 84037-1815
Phone (801) 546-6868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170811001270 UT Practitioner - Physical Therapist in Private Practice 4082985890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Utah School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fit Quest Therapy and Rehabilitation Clinic LLCGroup PAC ID 8224197819, 4 clinicians

Practice addresses (Care Compare)

335 N 300
Suite 103
Kaysville, UT 84037-1815
Phone (801) 546-6868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1346574001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 S 300 W",
            "address_2": "103",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371815",
            "telephone_number": "801-546-6868",
            "fax_number": "801-546-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N 300 W",
            "address_2": "103",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371815",
            "telephone_number": "801-546-6868",
            "fax_number": "801-546-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "7305977-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.