NPIMap

Organization Active NPI

Neurorev PLLC

  • Physical Therapy Clinic/Center
  • Centerville, UT
National Provider Identifier
1598229155
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEUROREV PLLC
Practice address
520 N Market Place Dr Ste 200
Centerville, UT 84014-4904
Phone
(801) 243-6822
NPI assigned
Jan 29, 2019
Last updated
Jan 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Authorized official

Name
Jason Lee, PT
Title
Manager
Phone
(801) 243-6822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

520 N Market Place Dr Ste 200
Centerville, UT 84014-4904

Mailing address

520 N Market Place Dr Ste 200
Centerville, UT 84014-4904
Phone (801) 243-6822

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1598229155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MARKET PLACE DR STE 200",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840144904",
            "telephone_number": "801-243-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MARKET PLACE DR STE 200",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840144904",
            "telephone_number": "801-243-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROREV PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-243-6822",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.