Individual provider Active NPI

J Brinton Andersen, DC

  • Chiropractor
  • South Jordan, UT
National Provider Identifier
1134465271
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7965217-1202 Issued in UT
Practice address
10965 S River Front Pkwy
South Jordan, UT 84095-3538
Phone
(801) 380-4234
NPI assigned
Dec 18, 2012
Last updated
Dec 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7965217-1202 UT Primary

Addresses

Primary practice location

10965 S River Front Pkwy
South Jordan, UT 84095-3538

Mailing address

10965 S River Front Pkwy
South Jordan, UT 84095-3538
Phone (801) 380-4234

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7965217-1202UTMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1134465271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10965 S RIVER FRONT PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953538",
            "telephone_number": "801-380-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10965 S RIVER FRONT PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953538",
            "telephone_number": "801-380-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "J",
        "middle_name": "BRINTON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7965217-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.