Individual provider Active NPI

Jacob Ryan Hamblin

  • Physical Therapist
  • Park City, UT
National Provider Identifier
1417862194
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14287862-2401 Issued in UT
Practice address
1122 Center Dr Ste D350
Park City, UT 84098-6908
Phone
(435) 383-2026
Fax
(435) 994-3377
NPI assigned
Aug 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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 14287862-2401 UT Primary

Addresses

Primary practice location

1122 Center Dr Ste D350
Park City, UT 84098-6908

Mailing address

657 E Annaston PL Apt 1
Murray, UT 84107-5460
Phone (720) 278-0339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1786924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1417862194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E ANNASTON PL APT 1",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075460",
            "telephone_number": "720-278-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 CENTER DR STE D350",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986908",
            "telephone_number": "435-383-2026",
            "fax_number": "435-994-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-17",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "14287862-2401",
            "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 Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.