NPIMap

Organization Active NPI

Bear Lake Physical and Sports Therapy PC

  • Physical Therapist
  • Garden City, UT
National Provider Identifier
1669568481
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3519742401 Issued in UT
Legal business name
BEAR LAKE PHYSICAL AND SPORTS THERAPY PC
Practice address
95 West 50 South
Garden City, UT 84028-0276
Phone
(435) 946-2777
Fax
(435) 946-9777
NPI assigned
Oct 5, 2006
Last updated
Aug 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Authorized official

Name
Ruthann Jarman
Title
Director
Phone
(833) 946-2777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 3519742401 UT Primary

Addresses

Primary practice location

95 West 50 South
Garden City, UT 84028-0276

Mailing address

PO Box 276
Garden City, UT 84028-0276
Phone (435) 946-2777

Other names 1

  • Bear Lake Physical Therapy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121106000253 UT Part B Supplier - Clinic/Group Practice 2264537687 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Garden City, UT; Randolph, UT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bear Lake Phys Sprts Thrpy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1669568481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "city": "GARDEN CITY",
            "state": "UT",
            "postal_code": "840280276",
            "telephone_number": "435-946-2777",
            "fax_number": "435-946-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WEST 50 SOUTH",
            "city": "GARDEN CITY",
            "state": "UT",
            "postal_code": "840280276",
            "telephone_number": "435-946-2777",
            "fax_number": "435-946-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR LAKE PHYSICAL AND SPORTS THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "JARMAN",
        "authorized_official_first_name": "RUTHANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "833-946-2777"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "3519742401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear Lake Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Garden City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.