Individual provider Active NPI

Brandon Judd, MPT

  • Physical Therapist
  • Park City, UT
National Provider Identifier
1407876667
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
290772401 Issued in UT
Practice address
597 Parkway Dr. Ste C
Park City, UT 84098
Phone
(435) 649-7335
Fax
(435) 649-7568
NPI assigned
Jul 20, 2006
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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 290772401 UT Primary

Addresses

Primary practice location

597 Parkway Dr. Ste C
Park City, UT 84098

Mailing address

597 Parkway Dr. Ste C
Park City, UT 84098
Phone (435) 649-7335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627001403 UT Practitioner - Physical Therapist in Private Practice 0749225043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosenberg Cooley Metcalf LCGroup PAC ID 0042291510, 35 clinicians

Practice addresses (Care Compare)

6340 S 3000
Suite 200
Salt Lake City, UT 84121-3552
Phone (435) 655-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
290772401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosenberg Cooley Metcalf LC CurrentSince Oct 1, 2024 Accepting new patients
Rosenberg Cooley Metcalf LC CurrentSince Oct 1, 2024 Accepting new patients
Wasatch Physical Therapy & Sports Medicine at Park City Physical Therapist CurrentSince May 28, 2007 Accepting new patients
Peak Performance PT Physical Therapist Past Accepting new patients
Heber Valley Physical Therapy Inc Past Accepting new patients
Iron Horse PT Physical Therapist Past Accepting new patients
Registered Physical Therapists LLC Physical Therapist PastSince Jan 1, 2004 Accepting new patients

Locations

597 Parkway Dr
Ste C
Park City, UT 84098
Phone (435) 649-7335

900 Round Valley Dr
Ste 100
Park City, UT 84060
Phone (435) 655-6600

6340 S 3000 E
Ste 200
Salt Lake City, UT 84121
Phone (435) 655-6600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJFECD

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1407876667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 PARKWAY DR. STE C",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-649-7335",
            "fax_number": "435-649-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 PARKWAY DR. STE C",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-649-7335",
            "fax_number": "435-649-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "290772401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.