Organization Active NPI

Collard Chiropractic LLC

  • Chiropractor
  • West Jordan, UT
National Provider Identifier
1013583731
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
COLLARD CHIROPRACTIC LLC
Practice address
9071 S 1300 W Ste 105
West Jordan, UT 84088-6694
Phone
(801) 569-1141
Fax
(801) 569-1171
NPI assigned
Jun 2, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Chad L Collard, D.C.NPI 1184707036
Title
Doctor/ Member
Phone
(801) 569-1141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

9071 S 1300 W Ste 105
West Jordan, UT 84088-6694

Mailing address

9071 S 1300 W Ste 105
West Jordan, UT 84088-6694
Phone (801) 569-1141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210602001163 UT Part B Supplier - Clinic/Group Practice 1355740937 Receives reassigned benefits from 1 practitioner
Practice locations: West Jordan, UT

National Provider Directory

National Provider Directory

Locations

9071 S 1300 W
Ste 105
West Jordan, UT 84088
Phone (801) 569-1141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1013583731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9071 S 1300 W STE 105",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886694",
            "telephone_number": "801-569-1141",
            "fax_number": "801-569-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9071 S 1300 W STE 105",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886694",
            "telephone_number": "801-569-1141",
            "fax_number": "801-569-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLARD CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "COLLARD",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR/ MEMBER",
        "authorized_official_telephone_number": "801-569-1141",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.