Statera Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

10638431-1202 Issued in UT

Legal business name

STATERA CHIROPRACTIC LLC

Practice address

736 W Riverdale Road
Riverdale, UT 84405

Phone

(385) 288-0934

NPI assigned

Mar 15, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Gregory, DCNPI 1174030688

Title

Owner

Phone

(385) 288-0934

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Gregory, DC

  • Chiropractor
  • Riverdale, UT
  • NPI 1174030688
  Medicare reassignment NPD Authorized official
• Megan Ann Jacobson, DC

  • Chiropractor
  • Riverdale, UT
  • NPI 1912514662
  Medicare reassignment
• Taylor Williams, DC

  • Chiropractor
  • Riverdale, UT
  • NPI 1023975877
  NPD (past)

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1497258511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 W RIVERDALE ROAD",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "84405",
            "telephone_number": "385-288-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 W RIVERDALE ROAD",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "84405",
            "telephone_number": "385-288-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATERA CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-288-0934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "10638431-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Smith
• Madeline Smith, LCSW
• Madison Smith, BSN, RN, IBCLC
• Stephanie Marie Sneed, RBT
• Spring Dawn Nutrition, LLC
• Alyssa Steed
• Alisa Stewart, RBT
• Breanna Stewart
• Kaylee Stockett, CMHC
• Stoney Brooke Management Co.

• Chiropractor in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.