Individual provider Active NPI

Tiffany Wink, PT, DPT

  • Physical Therapist
  • Logan, UT
National Provider Identifier
1760862585
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12347162-2401 Issued in UT
Practice address
1300 N 500 E
Logan, UT 84341-2408
Phone
(435) 716-2880
NPI assigned
Jun 6, 2015
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12347162-2401 UT Primary
Physical Therapist 225100000X PT 30377 FL

Addresses

Primary practice location

1300 N 500 E
Logan, UT 84341-2408

Mailing address

PO Box 25537
Salt Lake City, UT 84125-0537

Other practice location 1

1845 Town Center Blvd
#410
Fleming Island, FL 32003-3356
Phone (904) 621-0396

Other names 1

  • Tiffany Bradford Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326003496 UT Practitioner - Physical Therapist in Private Practice 3476868225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
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)

1300 N 500
Logan, UT 84341-2408
Phone (435) 716-5010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 30377FLMDPhysical Therapist
12347162-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 19, 2024 Accepting new patients
Ihc Health Services Inc Physical Therapist CurrentSince Feb 19, 2024 Accepting new patients

Locations

1300 N 500 E
Logan, UT 84341
Phone (435) 716-2880

1300 N 500 E
Ste 130
Logan, UT 84341
Phone (435) 716-2800

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

905 N 1000 W
Tremonton, UT 84337
Phone (435) 207-4500

905 N 1000 W
#1
Tremonton, UT 84337

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1433548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1760862585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25537",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250537",
            "fax_number": "904-621-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412408",
            "telephone_number": "435-716-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Town Center Blvd",
            "address_2": "#410",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320033356",
            "country_code": "US",
            "telephone_number": "904-621-0396",
            "fax_number": "904-621-0397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINK",
        "first_name": "TIFFANY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-06",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12347162-2401",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 30377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "BRADFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.