NPIMap

Organization Active NPI

Ryseup Rehab Limited Liability Company

  • Physical Therapist
  • Provo, UT
National Provider Identifier
1699470609
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RYSEUP REHAB LIMITED LIABILITY COMPANY
Practice address
2230 N University Pkwy
BLDG 5, Ste B
Provo, UT 84604
Phone
(801) 449-0253
NPI assigned
Mar 31, 2023
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Mr. Cody Shawn Young
Title
Cfo
Phone
(801) 449-0253

Specialties & licenses 1

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

Addresses

Primary practice location

2230 N University Pkwy
BLDG 5, Ste B
Provo, UT 84604

Mailing address

2230 N University Pkwy
BLDG 5, Ste B
Provo, UT 84604
Phone (801) 449-0253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230818001123 UT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9133581440 Receives reassigned benefits from 4 practitioners
Practice locations: Provo, UT

National Provider Directory

National Provider Directory

Locations

2230 N University Pkwy
Ste 5B
Provo, UT 84604
Phone (801) 449-0253

2230 N University Pkwy
Ste 5
Provo, UT 84604
Phone (801) 449-0253

404 W 2230 N
Provo, UT 84604
Phone (801) 449-0253

Practitioners & affiliated clinicians

Practitioners 5

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": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1699470609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 N UNIVERSITY PKWY",
            "address_2": "BLDG 5, STE B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-449-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N UNIVERSITY PKWY",
            "address_2": "BLDG 5, STE B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-449-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYSEUP REHAB LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "801-449-0253",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.