NPIMap

Organization Active NPI

Tooele Family Chiropractic, Inc.

  • Chiropractor
  • Tooele, UT
National Provider Identifier
1699953752
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
370378-1202 Issued in UT
Legal business name
TOOELE FAMILY CHIROPRACTIC, INC.
Practice address
134 W 1180 N
Suite #5
Tooele, UT 84074-1483
Phone
(435) 882-1621
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Dr. Matthew Wade Peterson, D.C.
Title
President
Phone
(435) 882-1621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 370378-1202 UT Primary

Addresses

Primary practice location

134 W 1180 N
Suite #5
Tooele, UT 84074-1483

Mailing address

134 W 1180 N
Suite #5
Tooele, UT 84074-1483
Phone (435) 882-1621

Other identifiers 1

IdentifierTypeStateIssuer
87039551MedicaidUT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1699953752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W 1180 N",
            "address_2": "SUITE #5",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741483",
            "telephone_number": "435-882-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 W 1180 N",
            "address_2": "SUITE #5",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741483",
            "telephone_number": "435-882-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOELE FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-882-1621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "370378-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87039551",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.