Travis G. Jardine, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

359811-8019 Issued in UT

Practice address

5121 Cottonwood St
Murray, UT 84107-5701

Phone

(801) 507-5746

NPI assigned

Sep 16, 2010

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2010.

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1972811669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10725 SUGARBUSH CT",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958365",
            "telephone_number": "801-302-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 COTTONWOOD ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "TRAVIS",
        "middle_name": "G.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "359811-8019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet M Balbierz MD PC
• Lindsay Janke, PA-C
• Paige Janzen
• Jade Jaques
• Harold Jaramillo
• Jared S. Dowell, D.C., LLC
• Marissa Jarrett, DNP
• Daniel Jarvis
• Jenny Jarvis, ACMHC
• Jason B Dickerson DPM LC

• All providers in Murray, UT
• Physical Therapy Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.