JONATHAN LAVAN BUNDY (PT, DPT) – Physical Therapist, NPI 1255738118

JONATHAN LAVAN BUNDY (PT, DPT) is a healthcare provider. based in Brigham city, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. The NPI Number for JONATHAN LAVAN BUNDY (PT, DPT) is 1255738118

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
JONATHAN LAVAN BUNDY (PT, DPT)
NPI
1255738118
Phone
Not provided
Address
862 S MAIN ST
Enumeration Date
20 November 2014
Last Update Date
5 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357929400
Graduation Year
2022 (4 years ago)
PAC ID
5698156644
Group Practice PAC ID
1153587233
Professional Enrollment ID
I20220721002517
Address ID
UT843329775PR267XXPKWY500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:11State licenses:0Digital endpointsOther names

1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT

Provider Addresses for JONATHAN LAVAN BUNDY (PT, DPT)

  • 862 S MAIN ST

    SUITE 4

    BRIGHAM CITY, UT 843023320

    Phone:

    Type: Mailing

  • 862 S Main St

    Suite 4

    Brigham City, UT 843023320

    Phone: (435) 723-1799

    Type: Location

  • 4949 S 3535 W

    TAYLORSVILLE, UT 841292947

    Phone: (435) 757-7546

    Type: Mailing

  • 267 N SPRING CREEK PKWY

    PROVIDENCE, UT 843329775

    Phone: (435) 792-9400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220721002517IPhysical Therapist In Private PracticeUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities59518$0
97140Therapy procedure using manual technique, each 15 minutes44717$0
View full utilization report →

Insurance plans in this area (ZIP 84302)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153587233View full group profile
NameSpecialtyState
C H I R O P R A C T I CUT
-UT
Physical Therapist In Private PracticeUT

Reviews

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Frequently asked questions

What is JONATHAN LAVAN BUNDY (PT, DPT)'s NPI number?
JONATHAN LAVAN BUNDY (PT, DPT)'s NPI is 1255738118 — the number used across U.S. healthcare to identify this provider.
Is JONATHAN LAVAN BUNDY (PT, DPT) shown as active in public data?
Registry records indicate JONATHAN LAVAN BUNDY (PT, DPT) maintains an active NPI.
What area of care is associated with JONATHAN LAVAN BUNDY (PT, DPT)?
JONATHAN LAVAN BUNDY (PT, DPT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with JONATHAN LAVAN BUNDY (PT, DPT)?
Directory geography for JONATHAN LAVAN BUNDY (PT, DPT) centers on Brigham City, Utah.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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