Individual provider Active NPI

Andrew J Reheisse, D.C.

  • Sports Physician Chiropractor
  • Murray, UT
National Provider Identifier
1003217449
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
9123542-1202 Issued in UT
Practice address
1996 E 6400 S Ste 260
Murray, UT 84121-2173
Phone
(801) 944-1855
Fax
(385) 351-5950
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 9123542-1202 UT Primary
Chiropractor 111N00000X 9123542-1202 UT

Addresses

Primary practice location

1996 E 6400 S Ste 260
Murray, UT 84121-2173

Mailing address

7351 S Union Park Ave Ste 150
Midvale, UT 84047-1869
Phone (801) 944-1855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006000949 UT Practitioner - Chiropractic 0840410353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7351 S Union Park Ave
Suite 150
Midvale, UT 84047-1869
Phone (801) 944-1855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9123542-1202UTMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Sport & Spine Chiropractor CurrentSince Mar 1, 2016 Accepting new patients
Sports Chiropractic of Utah LLC Chiropractor PastSince May 20, 2017 Accepting new patients

Locations

1996 E 6400 S
Ste 260
Murray, UT 84121
Phone (801) 944-1855

6713 S 1300 E
Salt Lake City, UT 84121
Phone (801) 942-1912

7351 S Union Park Ave
Ste 150
Sandy, UT 84047
Phone (801) 944-1855

Networks

  • UT PPO
  • UT PPO D-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1003217449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7351 S UNION PARK AVE STE 150",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471869",
            "telephone_number": "801-944-1855",
            "fax_number": "385-351-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1996 E 6400 S STE 260",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841212173",
            "telephone_number": "801-944-1855",
            "fax_number": "385-351-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHEISSE",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "9123542-1202",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "9123542-1202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.