Organization Active NPI

Ford Family Chiropractic and Rejuvenation Center

  • Chiropractor
  • Layton, UT
National Provider Identifier
1679985576
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8062892-1202 Issued in UT
Legal business name
FORD FAMILY CHIROPRACTIC AND REJUVENATION CENTER
Practice address
101 N Fort LN
Ste.101
Layton, UT 84041-5682
Phone
(801) 546-0114
Fax
(801) 546-6915
NPI assigned
May 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Authorized official

Name
Dr. Brad Lamar Miller, D.C.NPI 1609157965
Title
Manager
Phone
(801) 546-0114

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 8062892-1202 UT Primary

Addresses

Primary practice location

101 N Fort LN
Ste.101
Layton, UT 84041-5682

Mailing address

101 N Fort LN
Ste.101
Layton, UT 84041-5682
Phone (801) 546-0114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140611000237 UT Part B Supplier - Clinic/Group Practice 7618191792 Receives reassigned benefits from 1 practitioner
Practice locations: Layton, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1679985576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N FORT LN",
            "address_2": "STE.101",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415682",
            "telephone_number": "801-546-0114",
            "fax_number": "801-546-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N FORT LN",
            "address_2": "STE.101",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415682",
            "telephone_number": "801-546-0114",
            "fax_number": "801-546-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORD FAMILY CHIROPRACTIC AND REJUVENATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-546-0114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "8062892-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.