Active NPI
Jordan Mousley, D.C.
- Chiropractor
- Midvale, UT
National Provider Identifier
1013465632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10071416-1202
- Practice address
- 6717 S 900 E Ste 101
Midvale, UT 84047-5755 - Phone
- (801) 432-7511
- Fax
- (801) 432-7516
- NPI assigned
- Sep 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 10071416-1202 | UT | Primary |
Addresses
Primary practice location
6717 S 900 E Ste 101
Midvale, UT 84047-5755
Mailing address
6717 S 900 E Ste 101
Midvale, UT 84047-5755
Phone (801) 432-7511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6717 S 900
Suite 101
Midvale, UT 84047-5755
Phone (801) 432-7511
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Sport & Spine | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Midvale, UT
- NPI 1104372184
-
- Sports Physician Chiropractor
- Murray, UT
- NPI 1649646969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1013465632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6717 S 900 E STE 101",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840475755",
"telephone_number": "801-432-7511",
"fax_number": "801-432-7516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6717 S 900 E STE 101",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840475755",
"telephone_number": "801-432-7511",
"fax_number": "801-432-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSLEY",
"first_name": "JORDAN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-12",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "10071416-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.