South Jordan Chiropractic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

374015-1202 Issued in UT

Legal business name

SOUTH JORDAN CHIROPRACTIC, LLC

Practice address

10456 S Redwood Rd
South Jordan, UT 84095-8501

Phone

(801) 446-5100

NPI assigned

Nov 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. R. Jay Shetlin, DC

Title

Member

Phone

(801) 446-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pain to Wellness Clinic Other name

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1649425000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10456 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958501",
            "telephone_number": "801-446-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10456 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958501",
            "telephone_number": "801-446-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JORDAN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "SHETLIN",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-446-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "UT",
            "license": "374015-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508947367",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain to Wellness Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Elise Sorensen
• Sherry Sorensen, ACMHC
• Karli Sorenson
• Guillermo Soto
• South Jordan Care Group LLC
• South Jordan PDC PLLC
• South Mountain Dialysis, LLC
• South Point Counseling Services, LLC
• South Valley Orthomed, PLLC
• South Valley Speech and Language, LLC

• Primary Care Clinic/Center in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Primary Care Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.