Brandon Stubbs, DPT
Individual provider Active NPI Physical Therapist · Kanab, UT
NPI 1508949165 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508949165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 62515042401 (UT)
- Practice address
- 355 North Main
Kanab, UT 84741 - Phone
- (435) 644-4199
- Fax
- (435) 644-8562
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain Land Rehabilitation LLC
Practice addresses (Care Compare)
11193 S Redwood Rd
Suite 101N
South Jordan, UT 84095-8354
Phone (801) 415-9343
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250926004499 | UT | Practitioner - Physical Therapist in Private Practice | 9638674757 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12294720-2401 | UT | MD | Physical Therapist |
| 62515042401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Land Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
| Registered Physical Therapists LLC | Past | Accepting new patients |
Locations
355 N Main St
Kanab, UT 84741
Phone (435) 644-4100
11193 S Redwood Rd
Ste 101N
South Jordan, UT 84095
Phone (801) 415-9343
4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62515042401 | UT | Yes |
Addresses
Primary practice location
355 North Main
Kanab, UT 84741
Mailing address
PO Box 711185
Salt Lake City, UT 84171
Phone (801) 942-3311
Other providers in Kanab, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.