Individual provider Active NPI

Cameron Jacob Bateman, DC

  • Chiropractor
  • South Jordan, UT
National Provider Identifier
1447443452
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5121570-1202 Issued in UT
Practice address
1654 W Reunion Ave
Ste B
South Jordan, UT 84095-4676
Phone
(801) 302-9680
Fax
(801) 254-4211
NPI assigned
Aug 22, 2007
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5121570-1202 UT Primary

Addresses

Primary practice location

1654 W Reunion Ave
Ste B
South Jordan, UT 84095-4676

Mailing address

1654 W Reunion Ave
Ste B
South Jordan, UT 84095-4676
Phone (801) 302-9680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071002000617 UT Practitioner - Chiropractic 3072608306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1654 W Reunion Ave
Suite B
South Jordan, UT 84095-4676
Phone (801) 302-9680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5121570-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bateman Chiropractic and Physiotherapy LLC Chiropractor CurrentSince Dec 22, 2008 Accepting new patients

Locations

1654 W Reunion Ave
Ste B
South Jordan, UT 84095
Phone (801) 302-9680

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1447443452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 W REUNION AVE",
            "address_2": "STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954676",
            "telephone_number": "801-302-9680",
            "fax_number": "801-254-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 W REUNION AVE",
            "address_2": "STE B",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954676",
            "telephone_number": "801-302-9680",
            "fax_number": "801-254-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "CAMERON",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5121570-1202",
            "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 Oct 24, 2018; 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.