Individual provider Active NPI

Gregory Lee Freebairn, DC

  • Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1043328388
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2783521202 Issued in UT
Practice address
6415 S 3000 E
Ste 250
Salt Lake City, UT 84121-6905
Phone
(801) 553-0366
Fax
(801) 553-0367
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2783521202 UT Primary

Addresses

Primary practice location

6415 S 3000 E
Ste 250
Salt Lake City, UT 84121-6905

Mailing address

6415 S 3000 E
Ste 250
Salt Lake City, UT 84121-6905
Phone (801) 553-0366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2783521202UTMDChiropractor

Networks

  • UT PPO D-SNP
  • UT PPO

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1043328388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 S 3000 E",
            "address_2": "STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216905",
            "telephone_number": "801-553-0366",
            "fax_number": "801-553-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 S 3000 E",
            "address_2": "STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216905",
            "telephone_number": "801-553-0366",
            "fax_number": "801-553-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEBAIRN",
        "first_name": "GREGORY",
        "middle_name": "LEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "2783521202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.