Individual provider Active NPI

Brian W Tolman, D.C.

  • Chiropractor
  • West Haven, UT
National Provider Identifier
1013953363
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5256286-1202 Issued in UT
Practice address
4645 South Midland Drive
Suite 2
West Haven, UT 84401-9507
Phone
(801) 731-9899
NPI assigned
Jun 22, 2006
Last updated
Jul 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5256286-1202 UT Primary

Addresses

Primary practice location

4645 South Midland Drive
Suite 2
West Haven, UT 84401-9507

Mailing address

4645 South Midland Drive
Suite 2
West Haven, UT 84401-9507
Phone (801) 731-9899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120905000116 UT Practitioner - Chiropractic 5193757953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Well Chiropractic , P.C.Group PAC ID 9830121698, 7 clinicians

Practice addresses (Care Compare)

3384 W 4600
Suite 1
West Haven, UT 84401-9222
Phone (801) 731-9899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Chiropractic , P.C. Chiropractor CurrentSince Feb 14, 2003 Accepting new patients

Locations

1290 E Highway 193
#102
Layton, UT 84040
Phone (801) 771-2200

3384 W 4600 S
Ste 1
West Haven, UT 84401
Phone (801) 731-9899

4645 Midland Dr
Ste 2
West Haven, UT 84401
Phone (801) 332-9139

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1013953363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 SOUTH MIDLAND DRIVE",
            "address_2": "SUITE 2",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844019507",
            "telephone_number": "801-731-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 SOUTH MIDLAND DRIVE",
            "address_2": "SUITE 2",
            "city": "WEST HAVEN",
            "state": "UT",
            "postal_code": "844019507",
            "telephone_number": "801-731-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLMAN",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5256286-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.