Individual provider Active NPI

Bryon Lamar Rosquist, DC

  • Chiropractor
  • Pleasant Grove, UT
National Provider Identifier
1730221706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
168454-1202 Issued in UT
Practice address
405 S 100 E #104
Pleasant Grove, UT 84062
Phone
(801) 785-9411
Fax
(801) 785-9417
NPI assigned
Feb 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 168454-1202 UT Primary

Addresses

Primary practice location

405 S 100 E #104
Pleasant Grove, UT 84062

Mailing address

405 S 100 E #104
Pleasant Grove, UT 84062
Phone (801) 785-9411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000384 UT Practitioner - Chiropractic 5890837991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ket Chiropractic, LLC Chiropractor CurrentSince Dec 8, 2024 Accepting new patients

Locations

405 S 100 E
Ste 104
Pleasant Grv, UT 84062
Phone (801) 785-9411

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730221706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S 100 E #104",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-9411",
            "fax_number": "801-785-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S 100 E #104",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-9411",
            "fax_number": "801-785-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSQUIST",
        "first_name": "BRYON",
        "middle_name": "LAMAR",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "168454-1202",
            "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 Jul 8, 2007; 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.