Individual provider Active NPI

Tyler Shawn Smith, DPT

  • Physical Therapist
  • Layton, UT
National Provider Identifier
1558039032
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12324708-2401 Issued in UT
Practice address
2075 University Park Blvd
Layton, UT 84041-1611
Phone
(801) 779-6366
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 12324708-2401 UT Primary

Addresses

Primary practice location

2075 University Park Blvd
Layton, UT 84041-1611

Mailing address

4401 Harrison Blvd
Ogden, UT 84403-3195

Other practice location 1

1355 Hinckley Drive
Ogden, UT 84401-0105
Phone (801) 387-6175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817001849 UT Practitioner - Physical Therapist in Private Practice 1557723871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 779-6366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Physical Therapist CurrentSince Jun 18, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 18, 2023 Accepting new patients

Locations

2075 University Park Blvd
Layton, UT 84041
Phone (801) 367-2775

1355 W 3400 S
Ogden, UT 84401
Phone (801) 387-6150

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1558039032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 UNIVERSITY PARK BLVD",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411611",
            "telephone_number": "801-779-6366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 Hinckley Drive",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844010105",
            "country_code": "US",
            "telephone_number": "801-387-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "middle_name": "SHAWN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12324708-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.