Individual provider Active NPI

Brandon Kenneth Bliss, DPT

  • Physical Therapist
  • Lehi, UT
National Provider Identifier
1720167752
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3085245-2401 Issued in UT
Practice address
3401 N Center St Ste 200
Lehi, UT 84043-7499
Phone
(385) 309-1951
Fax
(385) 248-5690
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 3085245-2401 UT Primary

Addresses

Primary practice location

3401 N Center St Ste 200
Lehi, UT 84043-7499

Mailing address

9070 W Cheyenne Ave Ste 100
Las Vegas, NV 89129-8935
Phone (702) 818-5000

Other practice location 1

3303 N University Ave
Provo, UT 84604-4438
Phone (801) 373-7438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061204000233 UT Practitioner - Physical Therapist in Private Practice 7113926049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine Orthopedic and Sports Physical Therapy LLCGroup PAC ID 1850320805, 11 clinicians

Practice addresses (Care Compare)

3303 N University Ave
Provo, UT 84604-4438
Phone (801) 373-7438

3401 N Ctr St
Suite 200
Lehi, UT 84043-7499
Phone (385) 309-1951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Orthopedic & Sports Physical Therapy LLC Physical Therapist CurrentSince Aug 7, 2006 Accepting new patients
Fyzical Audiology LLC PastSince Apr 17, 2020 Accepting new patients
Orem Sports Medicine Center, LLC Physical Therapist PastSince Mar 7, 2016 Accepting new patients

Locations

9070 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129
Phone (702) 268-7213

3401 N Center St
Ste 200
Lehi, UT 84043
Phone (385) 309-1951

3303 N University Ave
Provo, UT 84604
Phone (801) 373-7438

524 W 300 N
Ste 201
Provo, UT 84601
Phone (801) 226-0599

Organizations & group practices 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1720167752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298935",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CENTER ST STE 200",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437499",
            "telephone_number": "385-309-1951",
            "fax_number": "385-248-5690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 N University Ave",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846044438",
            "country_code": "US",
            "telephone_number": "801-373-7438",
            "fax_number": "801-373-7486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLISS",
        "first_name": "BRANDON",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "3085245-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.