Active NPI
Tyler Leroy Nelson, D.C.
- Sports Physician Chiropractor
- Taylorsville, UT
National Provider Identifier
1396159885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 9027817-1202
- Practice address
- 1951 W 4700 S Ste 2
Taylorsville, UT 84129-1108 - Phone
- (801) 878-7356
- Fax
- (801) 878-7436
- NPI assigned
- Jun 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 9027817-1202 | UT | Primary |
Addresses
Primary practice location
1951 W 4700 S Ste 2
Taylorsville, UT 84129-1108
Mailing address
1951 W 4700 S Ste 2
Taylorsville, UT 84129-1108
Phone (801) 878-7356
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9027817-1202 | UT | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1396159885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1951 W 4700 S STE 2",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841291108",
"telephone_number": "801-878-7356",
"fax_number": "801-878-7436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 W 4700 S STE 2",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841291108",
"telephone_number": "801-878-7356",
"fax_number": "801-878-7436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "TYLER",
"middle_name": "LEROY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-12",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "UT",
"license": "9027817-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.