Leading Edge Chiropractic, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

367520-1201 Issued in UT

Legal business name

LEADING EDGE CHIROPRACTIC, INC

Practice address

301 S 200 E
Suite 1
Roosevelt, UT 84066-3129

Phone

(435) 722-1461

Fax

(435) 722-1444

NPI assigned

May 14, 2015

Organization subpart

No

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

Authorized official

Name

Joseph Dean Fitzgerald, DC

Title

Chiropractor

Phone

(435) 722-1461

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ronald Eugene Perry, D.C.

  • Chiropractor
  • Malad City, ID
  • NPI 1346477668
  NPD (past)

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1679951263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 200 E",
            "address_2": "SUITE 1",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663129",
            "telephone_number": "435-722-1461",
            "fax_number": "435-722-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 200 E",
            "address_2": "SUITE 1",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663129",
            "telephone_number": "435-722-1461",
            "fax_number": "435-722-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "435-722-1461",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "367520-1201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Robert Kresge, PT, DPT
• Sydnee Kunz
• Brett C Larsen, PA
• Jason Jerry Larson, M.D.
• George Scott Laub
• Jeffrey Brinkerhoff Luke, RPH
• Suzanne Maddocks, LCSW
• Makana Leadership Academy
• John David Marett, MD
• Sterling Marx

• Chiropractor in Roosevelt, UT
• Providers in Roosevelt, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.