Jared James Hultquist, PT, DPT
Individual provider Active NPI Physical Therapist · Centerville, UT
NPI 1477030583 · NPPES record last updated Dec 27, 2022
Key facts
- NPI
- 1477030583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10877360-8016 (UT)
- Practice address
- 35 W 50 S
Centerville, UT 84014-2376 - Phone
- (801) 827-0202
- Fax
- (385) 489-2243
- NPI assigned
- Jul 20, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Motion Ut, LLC
Practice addresses (Care Compare)
4554 Forestdale Dr
Unit C16
Park City, UT 84098-1392
Phone (603) 568-9461
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181107003672 | UT | Practitioner - Physical Therapist in Private Practice | 5991059099 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10877360-8016 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Motion Ut, LLC | Current |
Accepting new patients | |
| Total Rehab, Inc. | Physical Therapist | Past |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10877360-8016 | UT | Yes |
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
1741 N 2000 W
Farr West, UT 84404-9810
Phone (801) 827-0203
Other practice location 2
3476 W 4600 S
West Haven, UT 84401-9203
Phone (801) 689-0200
Other practice location 3
5957 Fashion Point Dr Ste 102
South Ogden, UT 84403-5180
Phone (801) 827-0200
Other providers in Centerville, UT
- Horizon Counseling Services
- David M. Huffaker
- Ford B. Huffaker
- Paul Huffaker
- Todd Huffaker
- Alexa Nicole Humphris
- Kajsa Hurtado
- Hutchinson Care Center LLC
- Integrated Dermatology of Bountiful LLC
- Madison Lee James
All providers in Centerville, 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 Dec 27, 2022. 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.