Jedidiah Richard Farley, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

10943391-1202 Issued in UT

Practice address

2040 E Murray Holladay Rd
Suite 102 a
Holladay, UT 84117

Phone

(801) 372-5864

Fax

(385) 695-5984

NPI assigned

Feb 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• UT PPO D-SNP
• UT PPO

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1053902106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 S. 2700 E",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-960-5005",
            "fax_number": "385-695-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E MURRAY HOLLADAY RD",
            "address_2": "SUITE 102 A",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "801-372-5864",
            "fax_number": "385-695-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "JEDIDIAH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "10943391-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Caldwell Evans
• Evidence Based Treatment Centers of Salt Lake City, PLLC
• Evnsq, LLC
• Evnsq, LLC
• Lucy Ann Falk
• Jonathan Glen Farrington, OTR/L
• Carrie Jo Ferguson
• Lindsay Ferguson
• Suzanne Marie Fields, L.C.S.W.
• Michelle Flowers, CCC-SLP

• Sports Physician Chiropractor in Holladay, UT
• Providers in Holladay, UT by specialty
• Sports Physician Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.