Douglas Gregory, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10638431-1202 Issued in UT

Practice address

736 W Riverdale Road
Riverdale, UT 84405-3715

Phone

(385) 288-0934

NPI assigned

Jan 5, 2018

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

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

• Statera Chiropractic LLC

  • Chiropractor
  • Riverdale, UT
  • NPI 1497258511
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1174030688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2588 N 500 W",
            "city": "SUNSET",
            "state": "UT",
            "postal_code": "840152575",
            "telephone_number": "385-288-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 W RIVERDALE ROAD",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053715",
            "telephone_number": "385-288-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-05",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "10638431-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "82-1177345",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Beth Glasock
• Tawnya Gonzales
• Alex Goodrich
• Adrian Shaniece Green
• Brady Korry Green, PHARMD
• Hannah Griffin
• Allison Griffiths
• Melissa Grace Grogan, RBT
• Andrea Christine Gunnerson, RPH
• Mark Henry Habermeyer, DDS

• Chiropractor in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.