Active NPI
Scott Michael Jerome, PT
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1861571648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 283650-2401
- Practice address
- 44 N Medical Dr
Salt Lake City, UT 84113-1105 - Phone
- (801) 883-4646
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 283650-2401 | UT | Primary |
| Pediatric Physical Therapist | 2251P0200X | 283650-2401 | UT |
Addresses
Primary practice location
44 N Medical Dr
Salt Lake City, UT 84113-1105
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Other practice location 1
5770 S Fashion Blvd Bldg 5 Suite 210
Murray, UT 84107
Phone (801) 314-5220
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Bluemark LLC/ Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shriners Hospitals for Children | Current | Accepting new patients | |
| Shriners Hospitals for Children | Current | Accepting new patients | |
| Shriners Hospitals for Children | Past | Accepting new patients |
Locations
1275 E Fairfax Rd
Salt Lake City, UT 84103
Phone (801) 536-3500
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.
-
- Pediatric Orthopaedic Surgery Physician
- Salt Lake City, UT
- NPI 1396187282
-
- Rehabilitation Clinic/Center
- Salt Lake City, UT
- NPI 1033789755
-
- Orthopaedic Surgery Physician
- Lexington, KY
- NPI 1700223559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1861571648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131105",
"telephone_number": "801-883-4646"
}
],
"practiceLocations": [
{
"address_1": "5770 S Fashion Blvd Bldg 5 Suite 210",
"address_purpose": "LOCATION",
"city": "Murray",
"state": "UT",
"postal_code": "84107",
"country_code": "US",
"telephone_number": "801-314-5220",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEROME",
"first_name": "SCOTT",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "283650-2401",
"primary": true
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "UT",
"license": "283650-2401",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 8, 2026; 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.