Keegan Taylor, PT
Individual provider Active NPI Physical Therapist · Mapleton, UT
NPI 1912691577 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1912691577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 13392192-2401 (UT)
- Practice address
- 684 S 1600 W
Mapleton, UT 84664-4486 - Phone
- (801) 436-3119
- NPI assigned
- Jun 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Motion Ut, LLC
Practice addresses (Care Compare)
4554 Forestdale Dr
Unit C16
Park City, UT 84098-1392
Phone (603) 568-9461
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628002484 | UT | Practitioner - Physical Therapist in Private Practice | 7719346402 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13392192-2401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Motion Ut, LLC | Current |
Accepting new patients |
Locations
1716 N Highway 40
Ste 101
Heber City, UT 84032
Phone (435) 294-2664
4554 Forestdale Dr
Unit C16
Park City, UT 84098
Phone (435) 494-1336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13392192-2401 | UT | Yes |
Addresses
Primary practice location
684 S 1600 W
Mapleton, UT 84664-4486
Mailing address
684 S 1600 W
Mapleton, UT 84664-4486
Other providers in Mapleton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.