Organization Active NPI

Layton Physical Therapy & Sports Medicine Inc

  • Specialist
  • Layton, UT
National Provider Identifier
1720133507
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
274721-2401 Issued in UT
Legal business name
LAYTON PHYSICAL THERAPY & SPORTS MEDICINE INC
Practice address
1868 N. 1200 W.
Ste #a
Layton, UT 84041-1937
Phone
(801) 728-4624
Fax
(801) 776-3087
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Mr. Alan J Kerbs, P.T.NPI 1952485625
Title
Provider/Owner
Phone
(801) 728-4624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 274721-2401 UT Primary

Addresses

Primary practice location

1868 N. 1200 W.
Ste #a
Layton, UT 84041-1937

Mailing address

1868 N. 1200 W.
Ste #a
Layton, UT 84041-1937
Phone (801) 728-4624

Other identifiers 2

IdentifierTypeStateIssuer
528132106010MedicaidUT
000057903OtherUTMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050228000809 UT Part B Supplier - Clinic/Group Practice 3476506650 Receives reassigned benefits from 3 practitioners
Practice locations: Layton, UT

National Provider Directory

National Provider Directory

Locations

1868 N 1200 W
Ste A
Layton, UT 84041
Phone (801) 675-0608

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1720133507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 N. 1200 W.",
            "address_2": "STE #A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411937",
            "telephone_number": "801-728-4624",
            "fax_number": "801-776-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 N. 1200 W.",
            "address_2": "STE #A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411937",
            "telephone_number": "801-728-4624",
            "fax_number": "801-776-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAYTON PHYSICAL THERAPY & SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "KERBS",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "801-728-4624",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "274721-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528132106010",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000057903",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.