Mt. Olympus Clinic of Chiropractic Corporation

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

57703761202 Issued in UT

Legal business name

MT. OLYMPUS CLINIC OF CHIROPRACTIC CORPORATION

Practice address

715 E 3900 S
Suite 205-a
Salt Lake City, UT 84107-2182

Phone

(801) 268-4993

Fax

(801) 268-4241

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Lewis Haddock, D.C.NPI 1679775563

Title

Owner

Phone

(801) 268-4993

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Lewis Haddock, D.C.

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1679775563
  Medicare reassignment NPD Authorized official
• Dale Buehner

  • Chiropractor
  • Salt Lake City, UT
  • NPI 1225126220
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1043485188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E 3900 S",
            "address_2": "SUITE 205-A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072182",
            "telephone_number": "801-268-4993",
            "fax_number": "801-268-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E 3900 S",
            "address_2": "SUITE 205-A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072182",
            "telephone_number": "801-268-4993",
            "fax_number": "801-268-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. OLYMPUS CLINIC OF CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "HADDOCK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-268-4993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "UT",
            "license": "57703761202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mr Health, Inc.
• Smriti Mridha
• MSK Enterprise LLC
• Mt Ogden Eye Center LLC
• Mt Olympus Anesthesia
• Mt. Olympus Obstetrics and Gynecology
• Heidi Mathie Mucha, PH.D
• Aruni Sharmaine Ayanthi Mudalige, APRN
• Alana Mudrow
• Natalie Tippets Mudrow

• Community Health Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Community Health Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.