Individual provider Active NPI

Dallen Bart Lovell, PT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1912018110
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1187252401 Issued in UT
Practice address
4465 S 900 E
Suite 250
Salt Lake City, UT 84124-2456
Phone
(801) 293-8888
Fax
(801) 293-8890
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 1187252401 UT Primary

Addresses

Primary practice location

4465 S 900 E
Suite 250
Salt Lake City, UT 84124-2456

Mailing address

PO Box 307
Bountiful, UT 84011-0307
Phone (801) 294-6907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000021 UT Practitioner - Physical Therapist in Private Practice 0648346239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1187252401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Body Physical Therapy Physical Therapist CurrentSince Aug 15, 2008 Accepting new patients

Locations

4465 S 900 E
Ste 250
Salt Lake Cty, UT 84124
Phone (801) 293-8888

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1912018110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E",
            "address_2": "SUITE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242456",
            "telephone_number": "801-293-8888",
            "fax_number": "801-293-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELL",
        "first_name": "DALLEN",
        "middle_name": "BART",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "1187252401",
            "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 Oct 23, 2014; 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.