Physical Medicine Clinic Inc

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

1676421202 Issued in UT

Legal business name

PHYSICAL MEDICINE CLINIC INC

Practice address

7669 S 1700 W
West Jordan, UT 84084-4007

Phone

(801) 566-2449

Fax

(801) 566-5435

NPI assigned

Oct 6, 2010

Organization subpart

No

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

Authorized official

Name

Patrick B. Egbert, D.C.NPI 1750388765

Title

Owner and Chiropractor

Phone

(801) 566-2449

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick Egbert, D.C.

  • Orthopedic Chiropractor
  • West Jordan, UT
  • NPI 1750388765
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1366751430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7669 S 1700 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844007",
            "telephone_number": "801-566-2449",
            "fax_number": "801-566-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7669 S 1700 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844007",
            "telephone_number": "801-566-2449",
            "fax_number": "801-566-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "EGBERT",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER AND CHIROPRACTOR",
        "authorized_official_telephone_number": "801-566-2449",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "UT",
            "license": "1676421202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Denise Pfeffer, MD
• Tina Pham
• Brinnley Shalice Phelon
• Maya Arizona Phillips
• Phoenix Rising Behavior and Academic Consulting LLC
• Adrianna Pidgeon
• Alyssa Pieper
• Randall Thomas Pierce, M.S. CCC-SLP
• Whitnie Pierce, RN
• Hannah Piggott

• Orthopedic Chiropractor in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Orthopedic Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.