NPIMap

Organization Active NPI

Valley Physical Therapy PLLC

Doing business as Valley PT

  • Physical Therapy Clinic/Center
  • Eden, UT
National Provider Identifier
1730724808
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
VALLEY PHYSICAL THERAPY PLLC
Doing business as
Valley PT
Practice address
5460 E 2200 N Ste 3
Eden, UT 84310-9105
Phone
(801) 745-3200
Fax
(801) 745-6115
NPI assigned
Nov 13, 2019
Last updated
Jun 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Benjamin NichollsNPI 1558876896
Title
Owner
Phone
(801) 745-3200

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
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

5460 E 2200 N Ste 3
Eden, UT 84310-9105

Mailing address

1421 N 7275 E
Huntsville, UT 84317-9615
Phone (801) 920-9944

Other names 1

  • Valley PT Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200310000336 UT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6800224619 Receives reassigned benefits from 2 practitioners
Practice locations: Eden, UT

National Provider Directory

National Provider Directory

Locations

5460 E 2200 N
Eden, UT 84310

5460 E 2200 N
Ste 3
Eden, UT 84310
Phone (801) 745-3200

Practitioners & affiliated clinicians

Practitioners 4

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": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1730724808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N 7275 E",
            "city": "HUNTSVILLE",
            "state": "UT",
            "postal_code": "843179615",
            "telephone_number": "801-920-9944",
            "fax_number": "801-745-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 E 2200 N STE 3",
            "city": "EDEN",
            "state": "UT",
            "postal_code": "843109105",
            "telephone_number": "801-745-3200",
            "fax_number": "801-745-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-745-3200"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley PT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.