Corpus Sanum, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

4929944-2401 Issued in UT

Legal business name

CORPUS SANUM, INC

Practice address

1276 Wall Ave
Suite #2
Ogden, UT 84404-5657

Phone

(801) 781-0651

NPI assigned

May 14, 2015

Last updated

May 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas M Shepherd, PTNPI 1215962337

Title

Physical Therapist

Phone

(801) 781-0651

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, and the practitioner matching its NPPES authorized official.

• Douglas Shepherd, PT

  • Physical Therapist
  • Ogden, UT
  • NPI 1215962337
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1386022036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 WALL AVE",
            "address_2": "SUITE #2",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045657",
            "telephone_number": "801-781-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 WALL AVE",
            "address_2": "SUITE #2",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045657",
            "telephone_number": "801-781-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPUS SANUM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-781-0651",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "UT",
            "license": "4929944-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark David Corgiat, PHD
• Aaliyah Coria
• Cornerstone Caregiving West LLC
• Kirsten Amber Cornia
• Julie Corona
• Nick Richard Corrigan
• Mya Alicia Cortez
• Donna Marie J Cosentino, PHARMD
• Rebecca Rae Cotterell, RN
• Shaun Coulson

• Physical Therapy Clinic/Center in Ogden, UT
• Providers in Ogden, UT by specialty
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.