Individual provider Active NPI

Tyler Landgren

  • Orthopedic Physical Therapist
  • Ogden, UT
National Provider Identifier
1558712455
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
9801160-2401 Issued in UT
Practice address
5349 Adams Ave Pkwy Ste a
Ogden, UT 84405-4736
Phone
(801) 479-9865
Fax
(801) 479-5846
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 9801160-2401 UT Primary

Addresses

Primary practice location

5349 Adams Ave Pkwy Ste a
Ogden, UT 84405-4736

Mailing address

5349 Adams Ave Pkwy Ste a
Ogden, UT 84405-4736
Phone (801) 479-9865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728001778 UT Practitioner - Physical Therapist in Private Practice 3274826276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wasatch Therapy IncGroup PAC ID 3476524760, 10 clinicians

Practice addresses (Care Compare)

1916 N 700
Suite 240
Layton, UT 84041-5864
Phone (801) 784-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9801160-2401UTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Therapy Inc CurrentSince Jun 1, 2016 Accepting new patients
Wasatch Therapy Inc CurrentSince Jun 1, 2016 Accepting new patients

Locations

1916 N 700 W
Ste 240
Layton, UT 84041
Phone (801) 784-7373

5360 S 1900 W
Ste B3
Roy, UT 84067
Phone (801) 774-8600

5349 Adams Avenue Pkwy
Ste A
Washington Tr, UT 84405
Phone (801) 479-9865

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1558712455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 ADAMS AVE PKWY STE A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054736",
            "telephone_number": "801-479-9865",
            "fax_number": "801-479-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5349 ADAMS AVE PKWY STE A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054736",
            "telephone_number": "801-479-9865",
            "fax_number": "801-479-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGREN",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "9801160-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.