Wellspring Physical Therapy, Llc is a medicare enrolled "Physical Therapist" provider in Midway, Utah. Their current practice location is
210 E Main St Ste 111, Midway, Utah. You can reach out to their office (for appointments etc.) via phone at
(435) 657-0123.
Wellspring Physical Therapy, Llc is licensed to practice in Utah (license number 116187-2401) and it also participates in the medicare program. Wellspring Physical Therapy, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1265513774.
Healthcare Provider's Profile
Full Name | Wellspring Physical Therapy, Llc |
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Type | Facility |
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Speciality | Physical Therapist |
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Location | 210 E Main St Ste 111, Midway, Utah |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1265513774
- Provider Enumeration Date: 10/18/2006
- Last Update Date: 03/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 6709817273
- Enrollment ID: O20050824000582
Medical Identifiers
Medical identifiers for Wellspring Physical Therapy, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265513774 | NPI | - | NPPES |
5291725170001 | Medicaid | UT | |
67054 | Other | UT | PEHP |
11618724000001 | Other | UT | BCBS |
64-00532 | Other | UT | UNITEDHEALTHCARE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 116187-2401 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Wellspring Physical Therapy, Llc acts as a billing entity for following providers:
Provider Name | Krista J Clark |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
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Provider Identifiers | NPI Number: 1114935301 PECOS PAC ID: 8426089996 Enrollment ID: I20120118000000 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wellspring Physical Therapy, Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Wellspring Physical Therapy, Llc 210 E Main St Ste 111, Midway, UT 84049-6828 Ph: (435) 657-0123 | Wellspring Physical Therapy, Llc 210 E Main St Ste 111, Midway, UT 84049-6828 Ph: (435) 657-0123 |
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