Individual provider Active NPI

Tyson Jorgensen, DPT

  • Orthopedic Physical Therapist
  • Ogden, UT
National Provider Identifier
1972157576
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
11297410-2401 Issued in UT
Practice address
3895 Harrison Blvd
Ogden, UT 84403-2312
Phone
(801) 387-7678
NPI assigned
Jul 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 11297410-2401 UT Primary

Addresses

Primary practice location

3895 Harrison Blvd
Ogden, UT 84403-2312

Mailing address

2075 E 7550 S Apt E301
South Weber, UT 84405-9540
Phone (801) 645-6366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231107001058 UT Practitioner - Physical Therapist in Private Practice 0244687648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1915 W 5950
Roy, UT 84067-1454
Phone (801) 387-8240

7302 S Bingham Junction Blvd
Midvale, UT 84047-4804
Phone (801) 442-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11297410-2401UTMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 25, 2023 Accepting new patients

Locations

7302 S Bingham Junction Blvd
Midvale, UT 84047
Phone (801) 442-3300

1915 W 5950 S
Roy, UT 84067
Phone (801) 387-8100

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

5848 S Fashion Blvd
Salt Lake Cty, UT 84107
Phone (801) 314-4040

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1972157576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 E 7550 S APT E301",
            "city": "SOUTH WEBER",
            "state": "UT",
            "postal_code": "844059540",
            "telephone_number": "801-645-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032312",
            "telephone_number": "801-387-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "11297410-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.