Bear Lake Physical and Sports Therapy PC
Organization Active NPI Physical Therapist · Garden City, UT
NPI 1669568481 · NPPES record last updated Aug 13, 2025
Key facts
- NPI
- 1669568481
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3519742401 (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
- Organization subpart
- No
Authorized official
- Name
- Ruthann Jarman
- Title
- Director
- Phone
- (833) 946-2777
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 2
Practitioners 2
-
Kam E Jarman, MPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Bear Lake Phys Sprts Thrpy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 3519742401 | UT | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805197000 | Medicaid | ID | |
| 529198060001 | Medicaid | UT |
Other names
- Bear Lake Physical Therapy
Other providers in Garden City, UT
- Bear Lake Community Health Center Pharmacy
- Bear Lake Community Health Center, Inc.
- Bear Lake Community Health Center, Inc.
- Bear Lake County Memorial Hospital
- Bear Lake Drug Garden City
- Benjamin Charles Bosen
- Kristin K Buys
- Fred H Denison
- Nathan Gracey
- Health West, Inc.
All providers in Garden City, UT · Physical Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.