Individual provider Active NPI

Ronald Jack Travis Utter, D.C.

  • Chiropractor
  • Deltona, FL
National Provider Identifier
1366719619
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10487 Issued in FL
Practice address
2922 Howland Blvd Ste 2
Deltona, FL 32725-2900
Phone
(813) 900-7246
Fax
(813) 409-2180
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 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 CH 10487 FL Primary

Addresses

Primary practice location

2922 Howland Blvd Ste 2
Deltona, FL 32725-2900

Mailing address

448 Brown Pelican Dr.
Daytona Beach, FL 32119
Phone (407) 509-1414

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10487FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Injury Physicians of Town & Country Inc PastSince Aug 24, 2016 Accepting new patients
Get Inline, Inc PastSince Dec 16, 2020 Accepting new patients
No Utter Way Inc Chiropractor PastSince Mar 23, 2019 Accepting new patients
Preferred Injury Physicians of Orange City Chiropractor PastSince Jun 14, 2017 Accepting new patients
Preferred Injury Physicians of East Orlando Inc PastSince Jul 3, 2018 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1366719619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 BROWN PELICAN DR.",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32119",
            "telephone_number": "407-509-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 HOWLAND BLVD STE 2",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327252900",
            "telephone_number": "813-900-7246",
            "fax_number": "813-409-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTER",
        "first_name": "RONALD",
        "middle_name": "JACK TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.