Individual provider Active NPI

George Alfred Hartle, DC

  • Chiropractor
  • Roosevelt, UT
National Provider Identifier
1306885967
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
98-366364-1202 Issued in UT
Practice address
383 E Lagoon St
Roosevelt, UT 84066-3017
Phone
(435) 722-3370
Fax
(435) 722-3384
NPI assigned
Jun 6, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 98-366364-1202 UT Primary

Addresses

Primary practice location

383 E Lagoon St
Roosevelt, UT 84066-3017

Mailing address

383 E Lagoon St
Roosevelt, UT 84066-3017
Phone (435) 722-3370

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
98-366364-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roosevelt Chiropractic, P.C. 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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1306885967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 E LAGOON ST",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663017",
            "telephone_number": "435-722-3370",
            "fax_number": "435-722-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 E LAGOON ST",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663017",
            "telephone_number": "435-722-3370",
            "fax_number": "435-722-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLE",
        "first_name": "GEORGE",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "98-366364-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.