Bret Maiers, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8715597-2401 Issued in UT

Practice address

220 Millpond
Suite 109
Stansbury Park, UT 84074-9745

Phone

(435) 882-4144

Fax

(435) 882-4151

NPI assigned

Aug 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372
  NPD (past)
• Pinnacle-Mountain Land Therapy LC

  • Occupational Therapist
  • Stansbury, UT
  • NPI 1043227770

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1497061782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 FLANDRO DR 190",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832021975",
            "telephone_number": "208-233-2248",
            "fax_number": "208-233-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MILLPOND",
            "address_2": "SUITE 109",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749745",
            "telephone_number": "435-882-4144",
            "fax_number": "435-882-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIERS",
        "first_name": "BRET",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-24",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60168625",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8715597-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497061782",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497061782",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00877701",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Lee, DPT
• Jenny Rebecca Leffler, LCSW
• Jennifer B Littledike, PA-C
• Marianne Mabey, PHARMD
• Amanda Madrid, PA-C
• Gage Manzione, DPT
• Amber Margolis, LCSW
• Asia Roux Mazeiko, DPT
• McConnell Dental Care III
• James Farrell McConnell IV, DMD

• Physical Therapist in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.