Organization Active NPI

Bryan D. Gordon P.C.

  • Chiropractor
  • South Jordan, UT
National Provider Identifier
1477704484
Registry record updated Oct 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2774306-1202 Issued in UT
Legal business name
BRYAN D. GORDON P.C.
Practice address
11194 S Redwood Rd Unit 103
South Jordan, UT 84095-8207
Phone
(801) 562-1531
NPI assigned
Oct 8, 2008
Last updated
Oct 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2026

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

Authorized official

Name
Bryan GordonNPI 1093888232
Title
Owner
Phone
(801) 562-1531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2774306-1202 UT Primary

Addresses

Primary practice location

11194 S Redwood Rd Unit 103
South Jordan, UT 84095-8207

Mailing address

PO Box 95928
South Jordan, UT 84095-0928

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000096 UT Part B Supplier - Clinic/Group Practice 3678718525 Receives reassigned benefits from 1 practitioner
Practice locations: West Jordan, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792281600000",
    "number": "1477704484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95928",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11194 S REDWOOD RD UNIT 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958207",
            "telephone_number": "801-562-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN D. GORDON P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2026-10-18",
        "certification_date": "2026-10-18",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-562-1531"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "2774306-1202",
            "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 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.