Individual provider Active NPI

Marc Nelson, DC

  • Chiropractor
  • American Fork, UT
National Provider Identifier
1477073088
Registry record updated Aug 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
103409391202 Issued in UT
Practice address
456 E State Rd Ste 500
American Fork, UT 84003-2589
Phone
(801) 997-0564
NPI assigned
Jun 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 103409391202 UT Primary

Addresses

Primary practice location

456 E State Rd Ste 500
American Fork, UT 84003-2589

Mailing address

456 E State Street
Suite 500
American Fork, UT 84003
Phone (801) 642-4199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170901001298 UT Practitioner - Chiropractic 9638442221

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

456 E State Rd
Suite 500
American Fork, UT 84003-2589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103409391202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Chiropractic PLLC Chiropractor CurrentSince Aug 15, 2017 Accepting new patients

Locations

456 E State Rd
Ste 500
American Fork, UT 84003
Phone (801) 642-4199

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": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1477073088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 E STATE STREET",
            "address_2": "SUITE 500",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "84003",
            "telephone_number": "801-642-4199",
            "fax_number": "801-642-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 E STATE RD STE 500",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032589",
            "telephone_number": "801-997-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "103409391202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; 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.