Active NPI
I Clark Labrum, DC
- Orthopedic Chiropractor
- St George, UT
National Provider Identifier
1679660542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 222003
- Practice address
- 415 W Tabernacle St
St George, UT 84770-3348 - Phone
- (435) 673-2700
- Fax
- (435) 673-2714
- NPI assigned
- Oct 10, 2006
- 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 |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 222003 | UT | Primary |
Addresses
Primary practice location
415 W Tabernacle St
St George, UT 84770-3348
Mailing address
415 W Tabernacle St
St George, UT 84770-3348
Phone (435) 673-2700
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 222003 | UT | MD | Orthopedic Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1679660542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 W TABERNACLE ST",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847703348",
"telephone_number": "435-673-2700",
"fax_number": "435-673-2714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 W TABERNACLE ST",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847703348",
"telephone_number": "435-673-2700",
"fax_number": "435-673-2714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABRUM",
"first_name": "I",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "UT",
"license": "222003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.