Individual provider Active NPI

Trent Jacob Teegarden, D.C.

  • Chiropractor
  • Lehi, UT
National Provider Identifier
1396069225
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7280952-1202 Issued in UT
Practice address
1804 N 110 E
Lehi, UT 84043-5918
Phone
(801) 616-9775
Fax
(801) 268-8097
NPI assigned
Mar 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 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 7280952-1202 UT Primary

Addresses

Primary practice location

1804 N 110 E
Lehi, UT 84043-5918

Mailing address

1804 N 110 E
Lehi, UT 84043-5918
Phone (801) 616-9775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121231000070 OR Practitioner - Chiropractic 4587817408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Kristopher B Peterson DC PCGroup PAC ID 2365439262, 2 clinicians

Practice addresses (Care Compare)

1002 W Elm Ave
Hermiston, OR 97838-2711
Phone (541) 567-6277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7280952-1202UTMDChiropractor

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": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1396069225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 N 110 E",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435918",
            "telephone_number": "801-616-9775",
            "fax_number": "801-268-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 N 110 E",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435918",
            "telephone_number": "801-616-9775",
            "fax_number": "801-268-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEGARDEN",
        "first_name": "TRENT",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7280952-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.