Wasatch Physical Therapy & Sports Medicine at Park City

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WASATCH PHYSICAL THERAPY & SPORTS MEDICINE AT PARK CITY

Practice address

597 Parkway Dr
Suite C
Park City, UT 84098-5731

Phone

(435) 649-7335

Fax

(435) 649-7568

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dan S Ivie, MPTNPI 1861484131

Title

Owner

Phone

(435) 649-7335

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 10

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

• Dan Ivie, P.T

  • Physical Therapist
  • Park City, UT
  • NPI 1861484131
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Lynn Maki, DPT

  • Physical Therapist
  • Park City, UT
  • NPI 1871589895
  Medicare reassignment Care Compare group NPD
• Brandon Judd, MPT

  • Physical Therapist
  • Park City, UT
  • NPI 1407876667
  Medicare reassignment NPD
• Zachary Potts

  • Physical Therapist
  • Heber City, UT
  • NPI 1841745684
  Medicare reassignment NPD
• Lauren Ziaks, DPT, ATC, AIB-VR

  • Physical Therapist
  • Park City, UT
  • NPI 1467680835
  Medicare reassignment NPD
• Elise Amelia Begg, PT, DPT

  • Physical Therapist
  • Park City, UT
  • NPI 1164370433
  NPD (past)
• Marjorie Galvin Booth, PT

  • Physical Therapist
  • Park City, UT
  • NPI 1811143456
  NPD (past)
• Melissa Booth, MPT

  • Specialist
  • Heber City, UT
  • NPI 1588987549
  NPD (past)
• Dayton Ferguson, DPT

  • Community Health Worker
  • Heber City, UT
  • NPI 1164821682
  NPD (past)
• Rodney Edward Wade, DPT

  • Physical Therapist
  • Coalville, UT
  • NPI 1164448080
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526515200000",
    "number": "1730194507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 982287",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840982287",
            "telephone_number": "435-649-7335",
            "fax_number": "435-649-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 PARKWAY DR",
            "address_2": "SUITE C",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985731",
            "telephone_number": "435-649-7335",
            "fax_number": "435-649-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH PHYSICAL THERAPY & SPORTS MEDICINE AT PARK CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-05-17",
        "status": "A",
        "authorized_official_last_name": "IVIE",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-649-7335",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000057095",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Samuel Grey Walter
• Alison Warcup
• Wasatch Crest Treatment Services
• Wasatch NP House Calls LLC
• Wasatch Psychological Consultants
• Edward Robert Wassman Jr., M.D.
• Michael Watkins
• Jan Watts, PT
• We Healthy LLC

• Physical Therapist in Park City, UT
• Providers in Park City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.