Individual provider Active NPI

Jeffrey Hebert, D.C.

  • Sports Physician Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1457449290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
5377931-1202 Issued in UT
Practice address
6360 S 3000 E
Suite 360
Salt Lake City, UT 84121-6923
Phone
(801) 942-6000
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 5377931-1202 UT Primary

Addresses

Primary practice location

6360 S 3000 E
Suite 360
Salt Lake City, UT 84121-6923

Mailing address

5547 Fairview Dr
Park City, UT 84098-6162

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5377931-1202UTMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Avicenna PC Past Accepting new patients

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457449290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 FAIRVIEW DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E",
            "address_2": "SUITE 360",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216923",
            "telephone_number": "801-942-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "5377931-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.