Individual provider Active NPI

Eric Randall Brown, D.C.

  • Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1154628865
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8014253-1202 Issued in UT
Practice address
1200 E 3300 S
Salt Lake City, UT 84106-2522
Phone
(801) 256-6675
Fax
(801) 990-0503
NPI assigned
Feb 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CH60205190 WA
Chiropractor 111N00000X 8014253-1202 UT Primary

Addresses

Primary practice location

1200 E 3300 S
Salt Lake City, UT 84106-2522

Mailing address

1377 E 3900 S
Ste 100
Salt Lake City, UT 84124-1491
Phone (801) 256-6675

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925000836 UT Practitioner - Chiropractic 8527287697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1377 E 3900
Suite 100
Salt Lake City, UT 84124-1491
Phone (801) 256-6675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8014253-1202UTMDChiropractor
CH60205190WAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Chiropractic PLLC Chiropractor CurrentSince Sep 11, 2014 Accepting new patients

Locations

1200 E 3300 S
Millcreek, UT 84106
Phone (801) 256-6675

1377 E 3900 S
Ste 100
Salt Lake Cty, UT 84124
Phone (801) 256-6675

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1154628865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 E 3900 S",
            "address_2": "STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241491",
            "telephone_number": "801-256-6675",
            "fax_number": "801-990-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062522",
            "telephone_number": "801-256-6675",
            "fax_number": "801-990-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ERIC",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-15",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH60205190",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "8014253-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.