Individual provider Active NPI

Jared James Hultquist, PT, DPT

  • Physical Therapist
  • Centerville, UT
National Provider Identifier
1477030583
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10877360-8016 Issued in UT
Practice address
35 W 50 S
Centerville, UT 84014-2376
Phone
(801) 827-0202
Fax
(385) 489-2243
NPI assigned
Jul 20, 2018
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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 10877360-8016 UT Primary

Addresses

Primary practice location

35 W 50 S
Centerville, UT 84014-2376

Mailing address

PO Box 66
Hooper, UT 84315-0066
Phone (801) 689-0200

Other practice location 1

3476 W 4600 S
West Haven, UT 84401-9203
Phone (801) 689-0200

Other practice location 2

1741 N 2000 W
Farr West, UT 84404-9810
Phone (801) 827-0203

Other practice location 3

5957 Fashion Point Dr Ste 102
South Ogden, UT 84403-5180
Phone (801) 827-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181107003672 UT Practitioner - Physical Therapist in Private Practice 5991059099 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Motion Ut, LLCGroup PAC ID 0143630285, 6 clinicians

Practice addresses (Care Compare)

4554 Forestdale Dr
Unit C16
Park City, UT 84098-1392
Phone (603) 568-9461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10877360-8016UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Motion Ut, LLC CurrentSince Aug 12, 2024 Accepting new patients
Total Rehab, Inc. Physical Therapist PastSince Jan 1, 2008 Accepting new patients

Locations

1716 N Highway 40
Ste 101
Heber City, UT 84032
Phone (435) 294-2664

4554 Forestdale Dr
Unit C16
Park City, UT 84098
Phone (435) 494-1336

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": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1477030583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "HOOPER",
            "state": "UT",
            "postal_code": "843150066",
            "telephone_number": "801-689-0200",
            "fax_number": "801-689-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W 50 S",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142376",
            "telephone_number": "801-827-0202",
            "fax_number": "385-489-2243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3476 W 4600 S",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "UT",
            "postal_code": "844019203",
            "country_code": "US",
            "telephone_number": "801-689-0200",
            "fax_number": "801-689-0201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1741 N 2000 W",
            "address_purpose": "LOCATION",
            "city": "Farr West",
            "state": "UT",
            "postal_code": "844049810",
            "country_code": "US",
            "telephone_number": "801-827-0203",
            "fax_number": "801-407-9784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5957 Fashion Point Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "South Ogden",
            "state": "UT",
            "postal_code": "844035180",
            "country_code": "US",
            "telephone_number": "801-827-0200",
            "fax_number": "801-827-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULTQUIST",
        "first_name": "JARED",
        "middle_name": "JAMES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-20",
        "last_updated": "2022-12-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10877360-8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.