Individual provider Active NPI

Geoffrey Moultrie, D.C.

  • Chiropractor
  • Pleasant Grove, UT
National Provider Identifier
1215082615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5289181-1202 Issued in UT
Practice address
196 S Main St
Pleasant Grove, UT 84062-2631
Phone
(801) 785-9115
Fax
(801) 785-9195
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 5289181-1202 UT Primary

Addresses

Primary practice location

196 S Main St
Pleasant Grove, UT 84062-2631

Mailing address

2123 Tuscany Way
Pleasant Grove, UT 84062-8580
Phone (801) 796-9967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5289181-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Health Chiropractor Past Accepting new patients
Alternative Health Center, Inc Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215082615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 TUSCANY WAY",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840628580",
            "telephone_number": "801-796-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 S MAIN ST",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622631",
            "telephone_number": "801-785-9115",
            "fax_number": "801-785-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE",
        "first_name": "GEOFFREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5289181-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.