NPIMap

Organization Active NPI

Vector Spine and Sport LLC

  • Sports Physician Chiropractor
  • Millcreek, UT
National Provider Identifier
1740788876
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
10668583-1202 Issued in UT
Legal business name
VECTOR SPINE AND SPORT LLC
Practice address
3980 S 700 E Ste 23
Millcreek, UT 84107-2530
Phone
(801) 456-0352
Fax
(801) 456-0351
NPI assigned
Jan 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Dr. Jacob Duane Reesor, DC
Title
Owner
Phone
(801) 641-6571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 10668583-1202 UT Primary

Addresses

Primary practice location

3980 S 700 E Ste 23
Millcreek, UT 84107-2530

Mailing address

3980 S 700 E Ste 23
Millcreek, UT 84107-2530
Phone (801) 456-0352

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1740788876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 S 700 E STE 23",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841072530",
            "telephone_number": "801-456-0352",
            "fax_number": "801-456-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 S 700 E STE 23",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841072530",
            "telephone_number": "801-456-0352",
            "fax_number": "801-456-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VECTOR SPINE AND SPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "REESOR",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-641-6571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "10668583-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millcreek, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.