Individual provider Active NPI

Jack Scott Tripp, D.C.

  • Chiropractor
  • Midvale, UT
National Provider Identifier
1083045520
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8749241-1202 Issued in UT
Practice address
30 W 7200 S
Midvale, UT 84047-3723
Phone
(801) 707-9537
NPI assigned
Dec 10, 2013
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8749241-1202 UT Primary

Addresses

Primary practice location

30 W 7200 S
Midvale, UT 84047-3723

Mailing address

30 W 7200 S
Midvale, UT 84047-3723
Phone (801) 707-9537

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
8749241-1202UTMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1083045520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 7200 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840473723",
            "telephone_number": "801-707-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 7200 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840473723",
            "telephone_number": "801-707-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "JACK",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "8749241-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.