Individual provider Active NPI

Bradley Allan Guymon, DPT, PT

  • Physical Therapist
  • South Ogden, UT
National Provider Identifier
1881331536
Registry record updated May 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12447574-2401 Issued in UT
Practice address
5957 Fashion Point Dr Ste 102
South Ogden, UT 84403-5180
Phone
(801) 827-0200
Fax
(801) 827-0201
NPI assigned
May 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2022

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 12447574-2401 UT Primary

Addresses

Primary practice location

5957 Fashion Point Dr Ste 102
South Ogden, UT 84403-5180

Mailing address

PO Box 66
Hooper, UT 84315-0066
Phone (801) 689-0200

Other practice location 1

35 W 50 S Ste 100
Centerville, UT 84014-2376
Phone (801) 827-0202

Other practice location 2

3476 W 4600 S
West Haven, UT 84401-9203
Phone (801) 689-0200

Other practice location 3

1741 N 2000 W Ste 6
Farr West, UT 84404-9811
Phone (801) 827-0203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906003150 UT Practitioner - Physical Therapist in Private Practice 2769866078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Physical Therapy, Inc.Group PAC ID 2163676735, 14 clinicians

Practice addresses (Care Compare)

5957 Fashion Point Dr
Suite 102
Ogden, UT 84403-5180
Phone (801) 827-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12447574-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehab, Inc. Physical Therapist CurrentSince May 13, 2022 Accepting new patients
Utah Physical Therapy, Inc. Physical Therapist CurrentSince May 13, 2022 Accepting new patients

Locations

35 W 50 S
Ste 100
Centerville, UT 84014
Phone (801) 827-0202

1741 N 2000 W
Ste 6
Farr West, UT 84404
Phone (801) 689-0200

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

5957 Fashion Point Dr
South Ogden, UT 84403
Phone (385) 492-4930

3476 W 4600 S
West Haven, UT 84401
Phone (801) 689-0200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1881331536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "HOOPER",
            "state": "UT",
            "postal_code": "843150066",
            "telephone_number": "801-689-0200",
            "fax_number": "801-689-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 FASHION POINT DR STE 102",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844035180",
            "telephone_number": "801-827-0200",
            "fax_number": "801-827-0201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 W 50 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "UT",
            "postal_code": "840142376",
            "country_code": "US",
            "telephone_number": "801-827-0202",
            "fax_number": "385-489-2243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3476 W 4600 S",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "UT",
            "postal_code": "844019203",
            "country_code": "US",
            "telephone_number": "801-689-0200",
            "fax_number": "801-689-0201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1741 N 2000 W Ste 6",
            "address_purpose": "LOCATION",
            "city": "Farr West",
            "state": "UT",
            "postal_code": "844049811",
            "country_code": "US",
            "telephone_number": "801-827-0203",
            "fax_number": "801-407-9784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUYMON",
        "first_name": "BRADLEY",
        "middle_name": "ALLAN",
        "credential": "DPT,  PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-15",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12447574-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2022; 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.