Individual provider Active NPI

Scott Robert Allen, PT

  • Physical Therapist
  • Fillmore, UT
National Provider Identifier
1467865840
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1243460 Issued in TX
Practice address
770 S Highway 99
Fillmore, UT 84631
Phone
(435) 743-6100
Fax
(435) 743-6161
NPI assigned
Jun 3, 2014
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 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 1243460 TX Primary

Addresses

Primary practice location

770 S Highway 99
Fillmore, UT 84631

Mailing address

95 White Sage Ave
Delta, UT 84624-5555
Phone (435) 864-2551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170509001641 UT Practitioner - Physical Therapist in Private Practice 4486931086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

4179 S Riverboat Rd
Suite 110
Taylorsville, UT 84123-2595
Phone (801) 337-4475

770 S Hwy 99
Fillmore, UT 84631-5033
Phone (435) 743-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1243460TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Land Rehabilitation LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Registered Physical Therapists LLC Physical Therapist Past Accepting new patients

Locations

95 White Sage Ave
Delta, UT 84624
Phone (435) 864-2551

95 White Sage Ave
Ste C
Delta, UT 84624
Phone (435) 864-2251

770 S Highway 99
Fillmore, UT 84631
Phone (435) 253-8000

4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475

Organizations & group practices 3

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": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1467865840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WHITE SAGE AVE",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "846245555",
            "telephone_number": "435-864-2551",
            "fax_number": "435-864-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 S HIGHWAY 99",
            "city": "FILLMORE",
            "state": "UT",
            "postal_code": "84631",
            "telephone_number": "435-743-6100",
            "fax_number": "435-743-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-03",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1243460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fillmore, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.