Active NPI
Nathan S Gravley, PT
- Physical Therapist
- Payson, UT
National Provider Identifier
1356566020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5991
- Practice address
- 1000 Highway 6
Payson, UT 84651-1600 - Phone
- (801) 465-7070
- Fax
- (801) 465-7001
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT5991 | ID | Primary |
| Physical Therapist | 225100000X | 313219-2401 | UT |
Addresses
Primary practice location
1000 Highway 6
Payson, UT 84651-1600
Mailing address
3820 Crestwood LN
Idaho Falls, ID 83404-4979
Phone (208) 552-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5991 | ID | MD | Physical Therapist |
| 313219-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1356566020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3820 CRESTWOOD LN",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834044979",
"telephone_number": "208-552-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HIGHWAY 6",
"city": "PAYSON",
"state": "UT",
"postal_code": "846511600",
"telephone_number": "801-465-7070",
"fax_number": "801-465-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVLEY",
"first_name": "NATHAN",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT5991",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "313219-2401",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Payson, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.