Adam Marcus Fenenbock, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6736 Issued in MT

Practice address

175 W 400 N
Orem, UT 84057-4658

Phone

(801) 607-2707

NPI assigned

Dec 23, 2020

Last updated

Sep 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1336736420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W 400 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840574658",
            "telephone_number": "801-607-2707",
            "fax_number": "801-607-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W 400 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840574658",
            "telephone_number": "801-607-2707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 S Reserve St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598014755",
            "country_code": "US",
            "telephone_number": "406-549-2006",
            "fax_number": "406-549-6574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENENBOCK",
        "first_name": "ADAM",
        "middle_name": "MARCUS",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-23",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "6736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Orem, UT
• Providers in Orem, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.