Individual provider Active NPI

Amanda Gillmore, PHYSICAL THERAPY

  • Physical Therapist
  • West Jordan, UT
National Provider Identifier
1538037148
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8683181-2401 Issued in UT
Practice address
4705 W Pence Dr
West Jordan, UT 84088-1740
Phone
(801) 541-7373
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 8683181-2401 UT Primary

Addresses

Primary practice location

4705 W Pence Dr
West Jordan, UT 84088-1740

Mailing address

4705 W Pence Dr
West Jordan, UT 84088-1740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8683181-2401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1538037148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 W PENCE DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840881740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 W PENCE DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840881740",
            "telephone_number": "801-541-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMORE",
        "first_name": "AMANDA",
        "credential": "PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8683181-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.