Riley Willis Clyde, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12243556-2401 Issued in UT

Practice address

190 N Main St
Heber City, UT 84032-1600

Phone

(435) 654-0410

Fax

(435) 654-0440

NPI assigned

Sep 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Heber Valley Physical Therapy Inc

  • Specialist
  • Heber City, UT
  • NPI 1396802617
  Medicare reassignment

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1447921432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840320013",
            "telephone_number": "435-654-0410",
            "fax_number": "435-654-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N MAIN ST",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840321600",
            "telephone_number": "435-654-0410",
            "fax_number": "435-654-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "RILEY",
        "middle_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12243556-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hebervalleyphysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "connects to clinic website so that patients can contact us, see info for treatment courses, and view billing info.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "190 N Main St",
            "city": "Heber City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840321600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erick Reece Christensen, M.D.
• Julia Christensen
• Sarah M Christensen, OTR/L
• Paul K Clark, D.M.D.
• Riley Dean Clark, DMD
• Trent Clyde I, DPT
• Willis K Clyde, P.T.
• Community Health and Wellness, PLLC
• Christopher David Cook, D.O.
• Jessica Snyder Cooke, D.P.T.

• Physical Therapist in Heber City, UT
• Providers in Heber City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.