Individual provider Active NPI

Tyson L Herrick, PT

  • Physical Therapist
  • Orem, UT
National Provider Identifier
1740760834
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10861853-2401 Issued in UT
Practice address
1275 S 800 E
Orem, UT 84097-7232
Phone
(801) 224-7667
Fax
(801) 616-4098
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 10861853-2401 UT Primary

Addresses

Primary practice location

1275 S 800 E
Orem, UT 84097-7232

Mailing address

636 E State Rd
American Fork, UT 84003-2151
Phone (801) 492-6577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022002825 UT Practitioner - Physical Therapist in Private Practice 5597018556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

7302 S Bingham Junction Blvd
Midvale, UT 84047-4804
Phone (801) 442-5502

854 S Turf Farm Rd
Unit 1
Payson, UT 84651-5733
Phone (801) 357-2860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10861853-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Physical Therapist CurrentSince Sep 10, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 10, 2023 Accepting new patients

Locations

7302 S Bingham Junction Blvd
Midvale, UT 84047
Phone (801) 442-3300

854 S Turf Farm Rd
Unit 1
Payson, UT 84651
Phone (801) 357-2860

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

Organizations & group practices 2

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1740760834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 E STATE RD",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032151",
            "telephone_number": "801-492-6577",
            "fax_number": "801-492-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S 800 E",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977232",
            "telephone_number": "801-224-7667",
            "fax_number": "801-616-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRICK",
        "first_name": "TYSON",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10861853-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

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