Kevin Dee Church, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

119835-2401 Issued in UT

Practice address

5255 S 4015 W
Suite 205
Taylorsville, UT 84118-4257

Phone

(801) 957-1797

Fax

(801) 957-1941

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kevin Church Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Taylorsville, UT
  • NPI 1194022418
  Medicare reassignment Authorized official
• Excel Rehab Therapy LLC

  • Physical Therapist
  • Draper, UT
  • NPI 1477877744
  Medicare reassignment

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376678334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 S 4015 W",
            "address_2": "SUITE 205",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841184257",
            "telephone_number": "801-957-1797",
            "fax_number": "801-957-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 S 4015 W",
            "address_2": "SUITE 205",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841184257",
            "telephone_number": "801-957-1797",
            "fax_number": "801-957-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "KEVIN",
        "middle_name": "DEE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "119835-2401",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Christiansen
• John Chad Christiansen, D.C
• Macolin Christman
• Abigail Christoffersen, PHARMD
• Makenzie Christoffersen
• Aspen Clapper
• Anna Clark
• Anna Marie Clark, OTR/L
• Connor Clark
• Erica J Clark, PMHNP-BC

• Physical Therapist in Taylorsville, UT
• Providers in Taylorsville, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.