Active NPI
Kelly Reese Farmer
- Sports Physician Chiropractor
- Draper, UT
National Provider Identifier
1487316022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 10595795-1202
- Practice address
- 12371 S 900 E Ste 101
Draper, UT 84020-9834 - Phone
- (801) 544-2355
- NPI assigned
- Oct 12, 2021
- 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 | 10595795-1202 | UT | Primary |
Addresses
Primary practice location
12371 S 900 E Ste 101
Draper, UT 84020-9834
Mailing address
12371 S 900 E Ste 101
Draper, UT 84020-9834
Phone (801) 544-2355
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10595795-1202 | UT | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1487316022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12371 S 900 E STE 101",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209834",
"telephone_number": "801-544-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12371 S 900 E STE 101",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209834",
"telephone_number": "801-544-2355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARMER",
"first_name": "KELLY",
"middle_name": "REESE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "UT",
"license": "10595795-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.