Louis Howard Quackenbush II, D.P.T.
Individual provider Active NPI Physical Therapist · Delta, UT
NPI 1487780003 · NPPES record last updated Nov 8, 2018
Key facts
- NPI
- 1487780003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 285712-2401 (UT)
- Practice address
- 95 White Sage Ave
Suite C
Delta, UT 84624 - Phone
- (435) 864-2551
- Fax
- (435) 864-3573
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Washington University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain Land Rehabilitation LLC
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
95 White Sage Ave
Delta, UT 84624-5555
Phone (435) 864-2551
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040127000421 | UT | Practitioner - Physical Therapist in Private Practice | 1850292285 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Physical Therapy and Sports | Physical Therapist | Current |
Accepting new patients |
| Mountain Land Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
| Delta Physical Therapy and Sports Medicine PC | Physical Therapist | Current |
Accepting new patients |
| Registered Physical Therapists LLC | Past | Accepting new patients |
Locations
95 White Sage Ave
Ste C
Delta, UT 84624
Phone (435) 864-2251
674 S Highway 99
Fillmore, UT 84631
Phone (435) 743-5555
770 S Highway 99
Fillmore, UT 84631
Phone (435) 253-8000
4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 285712-2401 | UT | Yes |
Addresses
Primary practice location
95 White Sage Ave
Suite C
Delta, UT 84624
Mailing address
95 White Sage Ave
Suite C
Delta, UT 84624-5555
Phone (435) 864-2551
Other practice location 1
770 S Highway 99
Fillmore, UT 84631
Phone (435) 743-6100
Other names
- Dr. L Howard Quackenbush II
Other providers in Delta, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2018. 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.