Organization Active NPI

Colarusso Family Chiropractic, PC

  • Chiropractor
  • Riverton, UT
National Provider Identifier
1639350341
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5072634-1202 Issued in UT
Legal business name
COLARUSSO FAMILY CHIROPRACTIC, PC
Practice address
12571 S. Pasture Road
Suite E
Riverton, UT 84096-7037
Phone
(801) 878-3645
Fax
(801) 878-3647
NPI assigned
Nov 21, 2007
Organization subpart
Yes
Parent organization
COLARUSSO FAMILY CHIROPRACTIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. John Joseph Colarusso, D.C.NPI 1891860789
Title
Owner
Phone
(801) 878-3645

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5072634-1202 UT Primary

Addresses

Primary practice location

12571 S. Pasture Road
Suite E
Riverton, UT 84096-7037

Mailing address

12571 S. Pasture Road
Suite E
Riverton, UT 84096-7037
Phone (801) 878-3645

Other identifiers 1

IdentifierTypeStateIssuer
5072634-1202OtherUTUTAH LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071231000588 UT Part B Supplier - Clinic/Group Practice 7214017383 Receives reassigned benefits from 1 practitioner
Practice locations: Riverton, UT

National Provider Directory

National Provider Directory
Part of
Colarusso Family Chiropractic PC

Locations

12571 S Pasture Rd
Ste E
Riverton, UT 84096
Phone (801) 878-3645

12571 S Pasture Rd
Riverton, UT 84096

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1639350341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12571 S. PASTURE ROAD",
            "address_2": "SUITE E",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967037",
            "telephone_number": "801-878-3645",
            "fax_number": "801-878-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12571 S. PASTURE ROAD",
            "address_2": "SUITE E",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967037",
            "telephone_number": "801-878-3645",
            "fax_number": "801-878-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLARUSSO FAMILY CHIROPRACTIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLARUSSO FAMILY CHIROPRACTIC, PC",
        "enumeration_date": "2007-11-21",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "COLARUSSO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-878-3645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5072634-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH LICENSE",
            "identifier": "5072634-1202",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.