Uinta Spine Align

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

UINTA SPINE ALIGN

Doing business as

Davidson Chiropractic Clinic Evanston

Practice address

1425 Highway 150 S Ste 2
Evanston, WY 82930-5377

Phone

(307) 222-4322

Fax

(307) 444-4325

NPI assigned

Nov 29, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jay Dee Mangum, DCNPI 1699127159

Title

Owner/Ceo

Phone

(307) 222-4322

Specialties & licenses 1

Addresses

Other names 1

• Davidson Chiropractic Clinic Evanston Doing business as

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 1

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

• Jay Mangum, DC

  • Chiropractor
  • Katy, TX
  • NPI 1699127159

  WY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1104692375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HIGHWAY 150 S STE 2",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305377",
            "telephone_number": "307-222-4322",
            "fax_number": "307-444-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HIGHWAY 150 S STE 2",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305377",
            "telephone_number": "307-222-4322",
            "fax_number": "307-444-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UINTA SPINE ALIGN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "307-222-4322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davidson Chiropractic Clinic Evanston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Uinta Health Lab, LLC
• Uinta Home Sleep Testing
• Uinta Physical Therapy, Inc.
• Uinta Senior Citizens (Uinta Home Health and Hospice)
• Uinta Senior Citizens (Uinta Hospice)
• Uinta Urgent Care
• David Underwood, PEER SPECIALIST
• University of Utah Adult Services (EVANSTON REGIONAL HOSPITAL, CLINIC-Interventional Cardiology)
• University of Utah Adult Services (EVANSTON REGIONAL HOSPITAL-Emergency Physicians)
• Brennen Urrutia

• Chiropractor in Evanston, WY
• Providers in Evanston, WY by specialty
• Chiropractor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.