Individual provider Active NPI

Michael Perry Brown, DC

  • Chiropractor
  • Sandy, UT
National Provider Identifier
1295331916
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11256845-1202 Issued in UT
Practice address
10661 S State St
Sandy, UT 84070-4108
Phone
(801) 505-9054
Fax
(801) 890-0408
NPI assigned
Dec 8, 2020
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11256845-1202 UT Primary

Addresses

Primary practice location

10661 S State St
Sandy, UT 84070-4108

Mailing address

10661 S State St
Sandy, UT 84070-4108
Phone (801) 505-9054

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11256845-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Awaken Health Chiropractic Chiropractor CurrentSince Dec 13, 2020 Accepting new patients

Locations

10661 S State St
Sandy, UT 84070
Phone (801) 505-9054

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, 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": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1295331916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10661 S STATE ST",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704108",
            "telephone_number": "801-505-9054",
            "fax_number": "801-890-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10661 S STATE ST",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704108",
            "telephone_number": "801-505-9054",
            "fax_number": "801-890-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHAEL",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "11256845-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.