Individual provider Active NPI

Jonathan Krogue, DC

  • Chiropractor
  • Payson, UT
National Provider Identifier
1134748817
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11544936-1202 Issued in UT
Practice address
1172 E 100 N Ste 9
Payson, UT 84651-1691
Phone
(801) 691-1194
NPI assigned
Apr 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11544936-1202 UT Primary

Addresses

Primary practice location

1172 E 100 N Ste 9
Payson, UT 84651-1691

Mailing address

1172 E 100 N Ste 9
Payson, UT 84651-1691
Phone (801) 691-1194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715002932 UT Practitioner - Chiropractic 4385068907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1172 E 100
Suite 9
Payson, UT 84651-1691
Phone (801) 691-1194

207 N State St
Orem, UT 84057-4745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11544936-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Chiropractic Center, PLLC Chiropractor CurrentSince Apr 1, 2020 Accepting new patients
Krogue Chiropractic LLC Chiropractor CurrentSince May 20, 2020 Accepting new patients

Locations

207 N State St
Orem, UT 84057
Phone (801) 225-3481

1172 E 100 N
Ste 9
Payson, UT 84651
Phone (801) 477-0532

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1134748817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 E 100 N STE 9",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511691",
            "telephone_number": "801-691-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 E 100 N STE 9",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846511691",
            "telephone_number": "801-691-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROGUE",
        "first_name": "JONATHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-13",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "11544936-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.