Individual provider Active NPI

Theron Briggs Hall, DC

  • Chiropractor
  • South Jordan, UT
National Provider Identifier
1376768432
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3552091202 Issued in UT
Practice address
3630 West South Jordan Parkway
Suite 102
South Jordan, UT 84095
Phone
(801) 302-0301
Fax
(801) 302-0311
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3552091202 UT Primary

Addresses

Primary practice location

3630 West South Jordan Parkway
Suite 102
South Jordan, UT 84095

Mailing address

3630 W South Jordan Pkwy
Suite 102
South Jordan, UT 84095-7153
Phone (801) 302-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000114 UT Practitioner - Chiropractic 3476537515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10352 S River Heights Dr
Suite 102
South Jordan, UT 84095-9013
Phone (801) 302-0301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3552091202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bodyworks Chiropractic Center Inc Chiropractor CurrentSince Jan 1, 2008 Accepting new patients

Locations

10352 S River Heights Dr
Ste 102
South Jordan, UT 84095
Phone (801) 302-0301

1218 W South Jordan Pkwy
Ste A
South Jordan, UT 84095
Phone (801) 302-0301

Organizations & group practices 1

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1376768432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 W SOUTH JORDAN PKWY",
            "address_2": "SUITE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957153",
            "telephone_number": "801-302-0301",
            "fax_number": "801-302-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 WEST SOUTH JORDAN PARKWAY",
            "address_2": "SUITE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-302-0301",
            "fax_number": "801-302-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "THERON",
        "middle_name": "BRIGGS",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "3552091202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.