Roger Lynn Colvin, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

114380-2401 Issued in UT

Practice address

990 Medical Dr Ste U4
Brigham City, UT 84302-4714

Phone

(435) 723-6487

Fax

(435) 723-6490

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• RLC Physical Therapy & Rehab, LLC

  • Physical Therapist
  • Brigham City, UT
  • NPI 1801107495
  Authorized official Same address or phone
• KFDD Physical Therapy & Sports Medicine Clinic

  dba Sports Medicine Clinic

  • Physical Therapist
  • Ogden, UT
  • NPI 1013028505
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1740390988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE U4",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024714",
            "telephone_number": "435-723-6487",
            "fax_number": "435-723-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE U4",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024714",
            "telephone_number": "435-723-6487",
            "fax_number": "435-723-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "ROGER",
        "middle_name": "LYNN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "114380-2401",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "114380-2401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870375865000",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Clayburn
• Jeffrey Jordan Clifford
• Lindsay Jo Cole
• Jordan Douglas Colledge
• Theodore B Collins, CMHC
• Community Birth Group
• Community Health Centers, Inc. (Brigham City Medical & Dental Clinic)
• Christine Verenise Conrado, LCSW
• Nicole Conway, COUNSELOR
• Cook Foot & Ankle Specialists

• Physical Therapist in Brigham City, UT
• Providers in Brigham 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 Mar 10, 2008; 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.