INDEPENDENCE REHAB, LLC
NPI 1063781813
Physical Therapist in Provo, UT

Active since December 23, 2011
5314 N RIVER RUN DR STE 140, PROVO, UT 84604(801) 426-4905(801) 426-4953 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Independence Rehab, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INDEPENDENCE REHAB, LLC (NPI 1063781813) is a healthcare organization registered as a physical therapist in Provo, Utah and active in the NPI registry since December 2011. The organization lists Chad Fullmer, Vice President, as its authorized official.

NPPES Registry Identity

NPI1063781813
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameINDEPENDENCE REHAB, LLC
Location Address5314 N RIVER RUN DR STE 140Provo, UT 84604-7706
Mailing Address5314 N River Run Dr Ste 140Provo, UT 84604-7706 · (801) 426-4905 · Fax (801) 426-4953
Fax(801) 426-4953
Organization SubpartNo
Authorized OfficialChad FullmerVice President · (801) 494-0486
Enumeration DateDecember 23, 2011
Last NPPES UpdateMarch 24, 2026
NPPES CertifiedMarch 24, 2026
✔ NPI 1063781813 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
Also ListedOccupational TherapistTaxonomy 225X00000X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
5314 N RIVER RUN DR STE 140, Provo, UT 84604

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Independence Rehab, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

32

Medicare enrollment records show 32 clinicians reassign Medicare billing to Independence Rehab, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Occupational Therapist in Private Practice14
Physical Therapist in Private Practice13
Qualified Speech Language Pathologist5

Nearest to this location (20)

See all 32
Physical Therapist in Private Practice
NPI 1285760033
5314 RIVER RUN DR
Provo, UT 84604
(801) 426-4905
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1568599132
5314 RIVER RUN DR STE 140
Provo, UT 84604
(801) 426-4905
0.1 mi
Occupational Therapist in Private Practice
NPI 1083740658
5314 RIVER RUN DR STE 140
Provo, UT 84604
(801) 426-4905
✔ Accepts Medicare0.1 mi
Physical Therapist in Private Practice
NPI 1316214612
479 W 1400 N
Orem, UT 84057
(801) 426-4905
3.5 mi
Occupational Therapist in Private Practice
NPI 1962076455
267 WILLOW REED
Lehi, UT 84043
(801) 318-4470
✔ Accepts Medicare14 mi
Physical Therapist in Private Practice
NPI 1770876468
50 E 9000 S
Sandy, UT 84070
(801) 566-1613
✔ Accepts Medicare22 mi
Qualified Speech Language Pathologist
NPI 1669628756
1952 E 7000 S
Salt Lake City, UT 84121
(801) 495-5307
✔ Accepts Medicare24 mi
Occupational Therapist in Private Practice
NPI 1568917664
5171 S COTTONWOOD ST LOWER LEVEL 2 WOMEN'S CENTER COORDINATED REHAB SERVICES
Murray, UT 84107
(801) 507-7000
27 mi
Occupational Therapist in Private Practice
NPI 1700295862
201 E 2ND ST SUITE 18
Casper, WY 82601
(307) 472-3327
✔ Accepts Medicare327 mi
Physical Therapist in Private Practice
NPI 1225714512
4045 WADSWORTH BLVD STE 210
Wheat Ridge, CO 80033
(303) 953-3163
351 mi
Occupational Therapist in Private Practice
NPI 1326914060
1551 SUGARLAND DR
Sheridan, WY 82801
(307) 674-5575
✔ Accepts Medicare392 mi
Qualified Speech Language Pathologist
NPI 1154588838
1985 STADIUM DR
Sheridan, WY 82801
(307) 752-0282
✔ Accepts Medicare392 mi
Qualified Speech Language Pathologist
NPI 1467657395
111 W 36TH ST
Scottsbluff, NE 69361
(308) 635-2019
✔ Accepts Medicare431 mi
Occupational Therapist in Private Practice
NPI 1114565306
2100 CIRCLE DR
Scottsbluff, NE 69361
(307) 277-0090
✔ Accepts Medicare432 mi
Occupational Therapist in Private Practice
NPI 1932331428
6350 EUBANK BLVD NE APT. 724
Albuquerque, NM 87111
(860) 982-1064
✔ Accepts Medicare453 mi
Physical Therapist in Private Practice
NPI 1124331632
407 BLACK HILLS AVE
Alliance, NE 69301
(308) 762-6564
✔ Accepts Medicare474 mi
Physical Therapist in Private Practice
NPI 1447216726
2211 E SOUTHERN AVE
Phoenix, AZ 85040
(602) 305-7134
✔ Accepts Medicare477 mi
Physical Therapist in Private Practice
NPI 1982774899
353 FAIRMONT BLVD
Rapid City, SD 57701
(605) 719-1100
✔ Accepts Medicare504 mi
Qualified Speech Language Pathologist
NPI 1043418700
2470 S ARIZONA AVE
Yuma, AZ 85364
(928) 344-8541
✔ Accepts Medicare551 mi
Qualified Speech Language Pathologist
NPI 1063161123
1810 OLD GRANGER
Taylor, TX 76574
(512) 352-6337
✔ Accepts Medicare1,044 mi
See all 32 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Independence Rehab, LLC's NPI number?

The NPI number for Independence Rehab, LLC is 1063781813. It was assigned to this organization in the NPPES registry on December 23, 2011.

Where is Independence Rehab, LLC located?

Independence Rehab, LLC is located at 5314 N River Run Dr Ste 140, Provo, UT 84604. The listed phone number is (801) 426-4905.

What is Independence Rehab, LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Independence Rehab, LLC enrolled in Medicare?

Yes. Independence Rehab, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Independence Rehab, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 32 clinicians in 3 Medicare specialties reassign their Medicare billing to Independence Rehab, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Occupational Therapist in Private Practice (14), Physical Therapist in Private Practice (13) and Qualified Speech Language Pathologist (5). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Independence Rehab, LLC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Independence Rehab, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Independence Rehab, LLC was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.