Ryan Tueller Fuller, DPT
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Salt Lake City, UT
NPI 1922736859 · NPPES record last updated Aug 9, 2022
Key facts
- NPI
- 1922736859
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 12949582-2401 (UT)
- Practice address
- 5151 S 900 E Ste 100
Salt Lake City, UT 84117-6658 - Phone
- (801) 261-3321
- Fax
- (801) 261-5942
- NPI assigned
- Aug 9, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- West Virginia University School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Registered Physical Therapists Inc
Practice addresses (Care Compare)
74 E Kimballs LN
Suite 200
Draper, UT 84020-5005
Phone (801) 432-2070
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220824001394 | UT | Practitioner - Physical Therapist in Private Practice | 7618350679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Registered Physical Therapists LLC | Current |
Accepting new patients |
Locations
74 E Kimballs Ln
Ste 200
Draper, UT 84020
Phone (801) 432-2070
5151 S 900 E
Ste 100
Murray, UT 84117
Phone (801) 261-3321
9844 S 1300 E
Ste 300
Sandy, UT 84094
Phone (801) 572-0690
1577 W 7000 S
Ste 100
West Jordan, UT 84084
Phone (801) 566-6301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 12949582-2401 | UT | Yes |
Addresses
Primary practice location
5151 S 900 E Ste 100
Salt Lake City, UT 84117-6658
Mailing address
5151 S 900 E Ste 100
Salt Lake City, UT 84117-6658
Phone (801) 261-3321
Other providers in Salt Lake City, UT
- Lynnette Sue Fuller
- Margaret Fuller
- Matthew Fuller
- Matthew Joseph Fuller
- Polly Fuller
- Samuel Fuller
- Timothy Fuller
- Trenton C. Fuller
- Chase Brandon Fullerton
- Tamra Fullerton
All providers in Salt Lake City, UT · Physical Medicine & Rehabilitation Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2022. 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.