NPIMap

Organization Active NPI

Premere Rehab LLC

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1811278351
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PREMERE REHAB LLC
Practice address
1216 East 1300 South
Salt Lake City, UT 84105-1949
Phone
(801) 478-8965
NPI assigned
Aug 29, 2011
Last updated
Jan 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Authorized official

Name
Mike Billings
Title
President
Phone
(888) 757-3422

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1216 East 1300 South
Salt Lake City, UT 84105-1949

Mailing address

25117 SW Parkway Ave
Suite D
Wilsonville, OR 97070-9697
Phone (888) 757-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111130000600 UT Part B Supplier - Clinic/Group Practice 2567434764 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
Practice locations: Washington, UT

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mt Baker Care CenterBellingham, WA, CCN 505376 Skilled nursing facility Adp of the SNF Jan 1, 2023
Fairview ManorFairmont, NE, CCN 285206 Skilled nursing facility Adp of the SNF Sep 26, 2019
Sharon Care CenterCentralia, WA, CCN 505429 Skilled nursing facility Adp of the SNF Jan 1, 2024
View Ridge Care CenterEverett, WA, CCN 505362 Skilled nursing facility Adp of the SNF Dec 1, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1811278351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "888-757-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 EAST 1300 SOUTH",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841051949",
            "telephone_number": "801-478-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMERE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "BILLINGS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-757-3422"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.