UTAH VALLEY PHYSICAL MEDICINE AND REHABILITATION, PC – Physical Medicine & Rehabilitation Physician, NPI 1306163555
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for UTAH VALLEY PHYSICAL MEDICINE AND REHABILITATION, PC
PO BOX 95590
SOUTH JORDAN, UT 840950590
Phone: (801) 352-9500
Fax: (801) 352-7976
Type: Mailing
1050 E SOUTH TEMPLE
SALT LAKE CITY, UT 841021507
Phone: (801) 350-4111
Type: Location
3580 W 9000 S
West Jordan, UT 840888812
Phone: (801) 561-8888
Type: Location
PO BOX 1463
AMERICAN FORK, UT 840036463
Phone: (801) 772-1923
Fax: (801) 772-1927
Type: Mailing
1034 N 500 W
PROVO, UT 846043380
Phone: (801) 357-7765
Fax: (801) 772-1927
Type: Location
4252 S Birkhill Blvd
Murray, UT 841075715
Phone: (385) 425-0050
Type: Location
13747 S Redwood Rd
Riverton, UT 840655710
Phone: (801) 417-9400
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: 2010-09-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100910000841 | O | Clinic/Group Practice | UT | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84095)
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