Individual provider Active NPI

Trent Clyde I, DPT

  • Physical Therapist
  • Heber City, UT
National Provider Identifier
1366171001
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12849137-2401 Issued in UT
Practice address
190 N Main St
Heber City, UT 84032-1600
Phone
(435) 654-0410
Fax
(435) 654-0440
NPI assigned
Jun 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 12849137-2401 UT Primary

Addresses

Primary practice location

190 N Main St
Heber City, UT 84032-1600

Mailing address

PO Box 13
Heber City, UT 84032-0013
Phone (435) 654-0410

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

LicenseStateTypeSpecialty
12849137-2401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1366171001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840320013",
            "telephone_number": "435-654-0410",
            "fax_number": "435-654-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N MAIN ST",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840321600",
            "telephone_number": "435-654-0410",
            "fax_number": "435-654-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "TRENT",
        "name_suffix": "I",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12849137-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.