Individual provider Active NPI

Kristopher Hansen

  • Physical Therapist
  • Saint George, UT
National Provider Identifier
1417753047
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13957750-2401 Issued in UT
Practice address
352 E Riverside Dr
Saint George, UT 84790-6758
Phone
(435) 579-3494
Fax
(435) 213-2691
NPI assigned
Feb 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 13957750-2401 UT Primary

Addresses

Primary practice location

352 E Riverside Dr
Saint George, UT 84790-6758

Mailing address

840 S 400 E Apt 32
Saint George, UT 84770-5535
Phone (435) 313-5427

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021004050 UT Practitioner - Physical Therapist in Private Practice 6406344654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

133 Bremmer St
Richland, WA 99352-8421

840 S 400
Apt 32
St George, UT 84770-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13957750-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Physical Therapy & Wellness LLC Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients

Locations

352 E Riverside Dr
Ste A6
St George, UT 84790
Phone (204) 355-7934

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1417753047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S 400 E APT 32",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705535",
            "telephone_number": "435-313-5427",
            "fax_number": "435-213-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 E RIVERSIDE DR",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847906758",
            "telephone_number": "435-579-3494",
            "fax_number": "435-213-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "13957750-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.