Active NPI
Troy J Raven Jr., DC
- Chiropractor
- Pleasant Grove, UT
National Provider Identifier
1710720636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 12972586-1202
- Practice address
- 316 E State Rd
Pleasant Grove, UT 84062-3617 - Phone
- (801) 400-8732
- NPI assigned
- Jun 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 12972586-1202 | UT | |
| Pediatric Chiropractor | 111NP0017X | 12972586-1202 | UT | |
| Chiropractor | 111N00000X | 12972586-1202 | UT | Primary |
Addresses
Primary practice location
316 E State Rd
Pleasant Grove, UT 84062-3617
Mailing address
316 E State Rd
Pleasant Grove, UT 84062-3617
Phone (801) 400-8732
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12972586-1202 | UT | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1710720636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 E STATE RD",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840623617",
"telephone_number": "801-400-8732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 E STATE RD",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840623617",
"telephone_number": "801-400-8732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVEN",
"first_name": "TROY",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "UT",
"license": "12972586-1202",
"primary": false
},
{
"code": "111NP0017X",
"taxonomy_group": "",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "UT",
"license": "12972586-1202",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "12972586-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Grove, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.