Individual provider Active NPI

Walker J Riley

  • Physical Therapist
  • Logan, UT
National Provider Identifier
1669368742
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14223860-2401 Issued in UT
Practice address
258 S Main St Ste 210
Logan, UT 84321-5768
Phone
(435) 383-6120
Fax
(435) 557-8003
NPI assigned
Jun 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 14223860-2401 UT Primary

Addresses

Primary practice location

258 S Main St Ste 210
Logan, UT 84321-5768

Mailing address

PO Box 4682
Logan, UT 84323-4682
Phone (435) 514-5646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806004117 UT Practitioner - Physical Therapist in Private Practice 4880192178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14223860-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Medical Utah LLC CurrentSince Jun 10, 2025 Accepting new patients

Locations

258 S Main St
Ste 210
Logan, UT 84321
Phone (435) 383-6120

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1669368742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4682",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843234682",
            "telephone_number": "435-514-5646",
            "fax_number": "435-774-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S MAIN ST STE 210",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215768",
            "telephone_number": "435-383-6120",
            "fax_number": "435-557-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "WALKER",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "14223860-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.