NPIMap

Organization Active NPI

Total Rehab, Inc.

  • Physical Therapist
  • Brigham City, UT
National Provider Identifier
1801079439
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TOTAL REHAB, INC.
Practice address
250 American Way
Brigham City, UT 84302-2074
Phone
(435) 734-7178
NPI assigned
Dec 5, 2007
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Mont B Didericksen, MPTNPI 1063963825
Title
Ceo
Phone
(435) 734-7178

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 Therapist 225100000X UT Primary

Addresses

Primary practice location

250 American Way
Brigham City, UT 84302-2074

Mailing address

551 S 455 E
Smithfield, UT 84335-1355

National Provider Directory

National Provider Directory

Locations

250 N American Way
Brigham City, UT 84302
Phone (435) 734-6932

3350 Airport Rd
Ogden, UT 84405
Phone (801) 625-9330

5957 Fashion Point Dr
Ste 102
South Ogden, UT 84403
Phone (801) 827-0200

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1801079439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 S 455 E",
            "city": "SMITHFIELD",
            "state": "UT",
            "postal_code": "843351355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 AMERICAN WAY",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022074",
            "telephone_number": "435-734-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "DIDERICKSEN",
        "authorized_official_first_name": "MONT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-734-7178",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.