Individual provider Active NPI

Matt Thomas Lowell, MPT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1811022148
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
289433-2401 Issued in UT
Practice address
50 N Medical Dr
University Healthcare Burn Therapy
Salt Lake City, UT 84132-0001
Phone
(801) 581-2132
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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 289433-2401 UT Primary

Addresses

Primary practice location

50 N Medical Dr
University Healthcare Burn Therapy
Salt Lake City, UT 84132-0001

Mailing address

1557 Roosevelt Ave
Salt Lake City, UT 84105-2735
Phone (801) 647-0198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160901001052 WY Practitioner - Physical Therapist in Private Practice 3375839202 Reassigns benefits to 1 organization
I20210923001596 UT Practitioner - Physical Therapist in Private Practice 3375839202 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
289433-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Specialized Physical Therapy Inc. Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Shriners Hospitals for Children CurrentSince Aug 29, 2023 Accepting new patients

Locations

1275 E Fairfax Rd
Salt Lake City, UT 84103
Phone (801) 536-3500

620 W Cheyenne Dr
Evanston, WY 82930
Phone (307) 677-0669

Organizations & group practices 3

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1811022148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 ROOSEVELT AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052735",
            "telephone_number": "801-647-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "address_2": "UNIVERSITY HEALTHCARE BURN THERAPY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWELL",
        "first_name": "MATT",
        "middle_name": "THOMAS",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "289433-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.