GREGORY EDWARD RICKENBACKER (PT, DPT) – Physical Therapist, NPI 1962162073
Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GREGORY EDWARD RICKENBACKER (PT, DPT)
220 Millpond Ste 1069
Stansbury Park, UT 840749745
Phone: (435) 882-4144
Type: Location
416 N State Road 198
Salem, UT 846534605
Phone: (801) 423-8600
Type: Location
94 W Main St Ste 1
Santaquin, UT 846555584
Phone: (801) 754-5700
Type: Location
1122 Center Dr Ste D350
Park City, UT 840986908
Phone: (435) 383-2026
Type: Location
74 E 500 S Ste 104
Bountiful, UT 840106200
Phone: (801) 292-5011
Type: Location
5872 S 900 E Ste 150
Murray, UT 841211679
Phone: (801) 747-3889
Type: Location
4624 S Holladay Blvd
Holladay, UT 841177054
Phone: (801) 277-1028
Type: Location
2295 S Foothill Dr Ste 1
Salt Lake City, UT 841094006
Phone: (801) 846-7542
Type: Location
1227 W 9000 S Ste F
West Jordan, UT 840889010
Phone: (801) 282-2200
Type: Location
1153 E 3900 S
Salt Lake City, UT 841241201
Phone: (801) 262-6331
Type: Location
885 E 9400 S
Sandy, UT 840943670
Phone: (801) 562-0066
Type: Location
349 12th St
Ogden, UT 844045712
Phone: (801) 782-0300
Type: Location
1477 N 2000 W Ste A
Clinton, UT 840159099
Phone: (801) 773-4191
Type: Location
3072 W 300 N Ste A
West Point, UT 840153914
Phone: (801) 825-7500
Type: Location
2572 E South Weber Dr Ste 5
South Weber, UT 844059550
Phone: (801) 479-7045
Type: Location
2950 N Church St Ste 102
Layton, UT 840406590
Phone: (801) 574-9462
Type: Location
3225 W Gordon Ave Ste 3
Layton, UT 840415728
Phone: (801) 497-0800
Type: Location
29 S Main St
Tooele, UT 840742158
Phone: (435) 843-7466
Type: Location
1188 W Sportsplex Dr Ste 101
Kaysville, UT 840376816
Phone: (801) 547-1155
Type: Location
2532 S 5600 W
West Valley, UT 841201247
Phone: (801) 415-6882
Type: Location
1176 E 3745 S
SALT LAKE CITY, UT 841062443
Phone: (978) 886-7937
Type: Mailing
370 E SOUTH TEMPLE STE 150
SALT LAKE CITY, UT 841111279
Phone: (801) 521-9222
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: 2023-10-23
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 |
|---|---|---|---|---|
| I20231023001957 | I | Physical Therapist In Private 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 84074)
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