Individual provider Active NPI

Crystal Adamavich, DPT

  • Physical Therapist
  • Layton, UT
National Provider Identifier
1982262499
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11291404-2401 Issued in UT
Practice address
201 W Layton Pkwy FL 3
Layton, UT 84041-3692
Phone
(970) 331-5733
NPI assigned
May 30, 2019
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11291404-2401 UT Primary

Addresses

Primary practice location

201 W Layton Pkwy FL 3
Layton, UT 84041-3692

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (970) 331-5733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128002175 MI Practitioner - Physical Therapist in Private Practice 4284163890 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11291404-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Keweenaw CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince Nov 3, 2024 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1400 W Ice Lake Rd
Iron River, MI 49935
Phone (906) 265-6121

814 S Ice Lake Rd
Iron River, MI 49935
Phone (715) 847-2022

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

730 S 7th St
Ontonagon, MI 49953
Phone (906) 884-6054

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1982262499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "970-331-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LAYTON PKWY FL 3",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413692",
            "telephone_number": "970-331-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMAVICH",
        "first_name": "CRYSTAL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "11291404-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.