Justin Severn Utz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

15599 Issued in TX

Practice address

750 William D Fitch Pkwy Ste 240
College Station, TX 77845-7447

Phone

(979) 696-1996

NPI assigned

Jun 22, 2023

Last updated

Jun 22, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• College Station Chiropractic, P.C.

  • Chiropractor
  • College Station, TX
  • NPI 1922445337
  NPD

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1306522743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 TWEEDBROOK DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796365",
            "telephone_number": "832-341-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WILLIAM D FITCH PKWY STE 240",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457447",
            "telephone_number": "979-696-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTZ",
        "first_name": "JUSTIN",
        "middle_name": "SEVERN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF CHIROPRACTIC EXAMINERS LICENSE",
            "identifier": "15599",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in College Station, TX
• Providers in College Station, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.