Individual provider Active NPI

Nathan Wesley Elmore, DC

  • Nutrition Chiropractor
  • Syracuse, UT
National Provider Identifier
1679799902
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
5042020-1202 Issued in UT
Practice address
1842 South 2000 West
Syracuse, UT 84075
Phone
(801) 774-7540
Fax
(801) 774-7542
NPI assigned
Apr 17, 2007
Last updated
Dec 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 5042020-1202 UT Primary

Addresses

Primary practice location

1842 South 2000 West
Syracuse, UT 84075

Mailing address

1842 South 2000 West
# 2
Syracuse, UT 84075
Phone (801) 774-7540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000970 UT Practitioner - Chiropractic 8729039391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1747 Heritage LN
Suite B105
Syracuse, UT 84075-8546
Phone (801) 784-7274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5042020-1202UTMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elmore Chiropractic & Nutrition, LC CurrentSince Jul 1, 2013 Accepting new patients
Foothill Chiropractic, Inc Past Accepting new patients
Syracuse Chiropractic and Health Center LC Nutrition Past Accepting new patients

Locations

1747 Heritage Ln
Ste B105
Syracuse, UT 84075
Phone (801) 774-7540

1842 S 2000 W
Ste 2
Syracuse, UT 84075
Phone (801) 774-7540

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1679799902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 SOUTH 2000 WEST",
            "address_2": "# 2",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-774-7540",
            "fax_number": "801-774-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 SOUTH 2000 WEST",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-774-7540",
            "fax_number": "801-774-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "NATHAN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "UT",
            "license": "5042020-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.