Jason M Christiansen, DPT
Individual provider Active NPI Physical Therapist · North Logan, UT
NPI 1447360581 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1447360581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 59325882401 (UT)
- Practice address
- 2310 N 400 E
Ste C
North Logan, UT 84341 - Phone
- (435) 752-5200
- Fax
- (435) 752-5228
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Logan Physical Therapy PC
Practice addresses (Care Compare)
2310 N 400
Suite C
North Logan, UT 84341-1833
Phone (435) 752-5200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051213000262 | UT | Practitioner - Physical Therapist in Private Practice | 9335160845 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59325882401 | UT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 59325882401 | UT | Yes |
Addresses
Primary practice location
2310 N 400 E
Ste C
North Logan, UT 84341
Mailing address
PO Box 6518
North Logan, UT 84341
Phone (435) 752-5200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84854 | Other | UT | PEHP |
| 59325882400001 | Other | UT | BCBS |
Other providers in North Logan, UT
- Cache Valley Specialty Hospital
- Cache Valley Surgical Consultants, PC
- Camille Webb LLC
- Curtis Ray Canning
- Cannon Chiropractic LLC
- Dorothy Clayton Cobia
- Skye Cole
- Consulting Outside of the Box a Professional Corporation
- Earnest Cooper Jr.
- Kristin F Craig
All providers in North Logan, UT · Physical Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.