Peak Performance Chiropractic and Sports Rehabilitation Center LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

94077161202 Issued in UT

Legal business name

PEAK PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION CENTER LLC

Practice address

60 S 300 E
Delta, UT 84624-5551

Phone

(435) 864-2000

Fax

(435) 864-2002

NPI assigned

Aug 17, 2015

Last updated

May 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jordan Karl Mecham, D.C.NPI 1265816953

Title

Owner

Phone

(435) 406-1414

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jordan Karl Mecham, D.C.

  • Rehabilitation Chiropractor
  • Delta, UT
  • NPI 1265816953
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1194191817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S 400 W",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "846249233",
            "telephone_number": "435-864-2000",
            "fax_number": "435-864-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S 300 E",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "846245551",
            "telephone_number": "435-864-2000",
            "fax_number": "435-864-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "MECHAM",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "KARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-406-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "UT",
            "license": "94077161202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Delta, UT
• Providers in Delta, UT by specialty
• Rehabilitation Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.