Individual provider Active NPI

Justin Grant Brown, DPT

  • Physical Therapist
  • Provo, UT
National Provider Identifier
1497279228
Registry record updated Aug 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10385535-2401 Issued in UT
Practice address
524 W 300 N
Provo, UT 84601-2667
Phone
(801) 370-9981
NPI assigned
Aug 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2017

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 10385535-2401 UT Primary

Addresses

Primary practice location

524 W 300 N
Provo, UT 84601-2667

Mailing address

129 S 700 W
Provo, UT 84601-4251
Phone (801) 709-8744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170915002022 UT Practitioner - Physical Therapist in Private Practice 1254605173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orem Sports Medicine Center LLCGroup PAC ID 0941105191, 7 clinicians

Practice addresses (Care Compare)

524 W 300
Suite 201
Provo, UT 84601-2669
Phone (801) 370-9981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10385535-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orem Sports Medicine Center, LLC Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Spine Orthopedic & Sports Physical Therapy LLC Physical Therapist PastSince Aug 1, 2017 Accepting new patients

Locations

980 E 800 N
Ste 103
Orem, UT 84097
Phone (801) 226-0599

252 N State St
Orem, UT 84057
Phone (801) 226-0599

524 W 300 N
Ste 201
Provo, UT 84601
Phone (801) 226-0599

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1497279228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S 700 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846014251",
            "telephone_number": "801-709-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 W 300 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846012667",
            "telephone_number": "801-370-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JUSTIN",
        "middle_name": "GRANT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10385535-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; 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.