Individual provider Active NPI

Chad L Collard, D.C.

  • Chiropractor
  • West Jordan, UT
National Provider Identifier
1184707036
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3691541202 Issued in UT
Practice address
9103 S 1300 W Ste 101
West Jordan, UT 84088-6711
Phone
(801) 569-1141
Fax
(801) 569-1171
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3691541202 UT Primary

Addresses

Primary practice location

9103 S 1300 W Ste 101
West Jordan, UT 84088-6711

Mailing address

9103 South 1300 West Ste 101
West Jordan, UT 84088
Phone (801) 569-1141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040617000596 UT Practitioner - Chiropractic 1557345469 Reassigns benefits to 1 organization
Practice locations: West Jordan, UT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9071 S 1300
Suite 105
West Jordan, UT 84088-6694
Phone (801) 569-1141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3691541202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Collard Chiropractic LLC Chiropractor CurrentSince Jun 1, 2021 Accepting new patients

Locations

9071 S 1300 W
Ste 105
West Jordan, UT 84088
Phone (801) 569-1141

Networks

  • UT PPO D-SNP
  • UT PPO

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1184707036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9103 SOUTH 1300 WEST STE 101",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "84088",
            "telephone_number": "801-569-1141",
            "fax_number": "801-569-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9103 S 1300 W STE 101",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886711",
            "telephone_number": "801-569-1141",
            "fax_number": "801-569-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLARD",
        "first_name": "CHAD",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "3691541202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.