Gillian Beran-Maryott, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11819269-2401 Issued in UT

Practice address

165 S 1000 E
Salt Lake City, UT 84102-1402

Phone

(801) 322-5521

NPI assigned

Oct 14, 2020

Last updated

Oct 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

The Dental School at University of Texas HSC at San Antonio, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridgetown Physical Therapy and Training Studio PCGroup PAC ID 2264514652, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridgetown Physical Therapy and Training Studio, PC

  • Physical Therapist
  • Portland, OR
  • NPI 1194907873
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1932707635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S MAIN ST APT 4309",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153078",
            "telephone_number": "503-896-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S 1000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021402",
            "telephone_number": "801-322-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERAN-MARYOTT",
        "first_name": "GILLIAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "11819269-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa J Bentley, M.D.
• Janicka Bentz
• Rachel Benvegnu, PT, DPT
• Claire Jean Benvegu, R.PH.
• Jade Benzmiller
• Patricia Scallion Berckman, L.C.S.W.
• Drew Leo Berend
• Amy Louise Berens, OTR/L
• Malcolm M. Berenson, MD
• Allie Berg

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.