Organization Active NPI

Optimum Spine and Health Clinics, P.C.

  • Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1508015389
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2789521202 Issued in UT
Legal business name
OPTIMUM SPINE AND HEALTH CLINICS, P.C.
Practice address
4091 S Redwood Rd
Salt Lake City, UT 84123-1131
Phone
(801) 974-5555
Fax
(801) 974-1903
NPI assigned
Sep 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Dr. Gary E. Lee, D.C.
Title
President
Phone
(801) 974-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2789521202 UT Primary

Addresses

Primary practice location

4091 S Redwood Rd
Salt Lake City, UT 84123-1131

Mailing address

4091 S Redwood Rd
Salt Lake City, UT 84123-1131
Phone (801) 974-5555

National Provider Directory

National Provider Directory

Locations

4091 S Redwood Rd
Salt Lake City, UT 84123
Phone (801) 974-5555

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1508015389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4091 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841231131",
            "telephone_number": "801-974-5555",
            "fax_number": "801-974-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4091 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841231131",
            "telephone_number": "801-974-5555",
            "fax_number": "801-974-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM SPINE AND HEALTH CLINICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-974-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "2789521202",
            "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 Sep 16, 2008; 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.