Individual provider Active NPI

Justine Nicole Stevens, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Santaquin, UT
National Provider Identifier
1629814645
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
13980606-2401 Issued in UT
Practice address
94 N Highway 198
Santaquin, UT 84655-8231
Phone
(801) 754-5700
NPI assigned
Jul 9, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 13980606-2401 UT Primary

Addresses

Primary practice location

94 N Highway 198
Santaquin, UT 84655-8231

Mailing address

374 W 1860 S
Lehi, UT 84043-4925

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250514002855 CA Practitioner - Physical Therapist in Private Practice 6103344080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Park Physical Therapy Center IncGroup PAC ID 8426036765, 4 clinicians

Practice addresses (Care Compare)

1060 Camerado Dr
Cameron Park, CA 95682-8864
Phone (530) 676-7184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13980606-2401UTMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Land Rehabilitation LLC CurrentSince Aug 1, 2025 Accepting new patients
Cameron Park Physical Therapy Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients

Locations

1060 Camerado Dr
Cameron Park, CA 95682
Phone (530) 616-7184

94 N Highway 198
Santaquin, UT 84655
Phone (801) 754-5700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1629814645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 W 1860 S",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840434925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 N HIGHWAY 198",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846558231",
            "telephone_number": "801-754-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JUSTINE",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "UT",
            "license": "13980606-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santaquin, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.