Individual provider Active NPI

Brett James Haderlie, D.C.

  • Chiropractor
  • Lehi, UT
National Provider Identifier
1699931774
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
70596331202 Issued in UT
Practice address
380 E Main St
# E
Lehi, UT 84043-2228
Phone
(801) 768-2939
Fax
(801) 768-2955
NPI assigned
Jul 29, 2008
Last updated
Jul 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 70596331202 UT Primary

Addresses

Primary practice location

380 E Main St
# E
Lehi, UT 84043-2228

Mailing address

380 E Main St
# E
Lehi, UT 84043-2228
Phone (801) 768-2939

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

LicenseStateTypeSpecialty
70596331202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Andersen Family Chiropractic PC Chiropractor CurrentSince Jun 1, 2011 Accepting new patients

Locations

380 E Main St
Ste E
Lehi, UT 84043
Phone (801) 768-2939

Organizations & group practices 2

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1699931774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 E MAIN ST",
            "address_2": "# E",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432228",
            "telephone_number": "801-768-2939",
            "fax_number": "801-768-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 E MAIN ST",
            "address_2": "# E",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432228",
            "telephone_number": "801-768-2939",
            "fax_number": "801-768-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADERLIE",
        "first_name": "BRETT",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "70596331202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.