Rocky Mountain Clinic of Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6099655-1202 Issued in UT

Legal business name

ROCKY MOUNTAIN CLINIC OF CHIROPRACTIC LLC

Practice address

2240 N Hwy 89 Ste D
Harrisville, UT 84404-2824

Phone

(801) 782-2947

NPI assigned

Jun 2, 2006

Last updated

Oct 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick K. Mickelsen, D.O.NPI 1871549527

Title

Owner

Phone

(801) 782-2947

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick K. Mickelsen, D.C.

  • Chiropractor
  • Harrisville, UT
  • NPI 1871549527
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1346288594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 N HWY 89 STE D",
            "city": "HARRISVILLE",
            "state": "UT",
            "postal_code": "844042824",
            "telephone_number": "801-782-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 N HWY 89 STE D",
            "city": "HARRISVILLE",
            "state": "UT",
            "postal_code": "844042824",
            "telephone_number": "801-782-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN CLINIC OF CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "MICKELSEN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-782-2947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "6099655-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• McKenzie Rushton
• Michael A Russell, D.D.S.
• Paola Eridany Saldana
• Shae Schulthess
• Galia F Serrato Gosain, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.