Individual provider Active NPI

Rachel Alldredge, PTA

  • Physical Therapy Assistant
  • Grantsville, UT
National Provider Identifier
1619637667
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8506797-2402 Issued in UT
Practice address
822 E Main St Ste 16
Grantsville, UT 84029-2501
Phone
(435) 882-1263
NPI assigned
Dec 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8506797-2402 UT Primary

Addresses

Primary practice location

822 E Main St Ste 16
Grantsville, UT 84029-2501

Mailing address

PO Box 70689
Salt Lake City, UT 84170-0689
Phone (801) 987-8600

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
8506797-2402UTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grantsville Physical Therapy PLLC CurrentSince Dec 21, 2021 Accepting new patients

Locations

822 E Main St
Ste 16
Grantsville, UT 84029
Phone (435) 882-1263

Organizations & group practices 1

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": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1619637667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70689",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841700689",
            "telephone_number": "801-987-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 E MAIN ST STE 16",
            "city": "GRANTSVILLE",
            "state": "UT",
            "postal_code": "840292501",
            "telephone_number": "435-882-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLDREDGE",
        "first_name": "RACHEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "8506797-2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.