Individual provider Active NPI

Benjamin Russell Gunn, D.C.

  • Chiropractor
  • American Fork, UT
National Provider Identifier
1073844973
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7540495-1202 Issued in UT
Practice address
340 W Main St
American Fork, UT 84003-2230
Phone
(801) 492-8188
Fax
(801) 492-3432
NPI assigned
Jan 18, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7540495-1202 UT Primary

Addresses

Primary practice location

340 W Main St
American Fork, UT 84003-2230

Mailing address

340 W Main St
American Fork, UT 84003-2230
Phone (801) 492-8188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000455 UT Practitioner - Chiropractic 2365578135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • UT PPO D-SNP
  • UT PPO

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": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1073844973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W MAIN ST",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032230",
            "telephone_number": "801-492-8188",
            "fax_number": "801-492-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W MAIN ST",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032230",
            "telephone_number": "801-492-8188",
            "fax_number": "801-492-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "BENJAMIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7540495-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.