NPIMap

Organization Active NPI

JT LLC

  • Sports Physician Chiropractor
  • Saint George, UT
National Provider Identifier
1770033672
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
6859851-1202 Issued in UT
Legal business name
JT LLC
Practice address
301 N 200 E
Suite 2C
Saint George, UT 84770-3010
Phone
(435) 218-7250
NPI assigned
Oct 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
Dr. Justin Traveller, M.S. D.C.NPI 1386820975
Title
Owner
Phone
(435) 256-2823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X 6859851-1202 UT Primary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X 7218960-1202 UT

Addresses

Primary practice location

301 N 200 E
Suite 2C
Saint George, UT 84770-3010

Mailing address

1865 S 2740 E
Saint George, UT 84790-7110
Phone (435) 256-2823

Other names 1

  • Healthology Experts Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161214002166 UT Part B Supplier - Clinic/Group Practice 5092095729 Receives reassigned benefits from 3 practitioners
Practice locations: St George, UT

National Provider Directory

National Provider Directory

Locations

1224 S River Rd
Ste B
St George, UT 84790

1224 S River Rd
Ste B100
St George, UT 84790
Phone (435) 218-7250

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1770033672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 S 2740 E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907110",
            "telephone_number": "435-256-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 200 E",
            "address_2": "SUITE 2C",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703010",
            "telephone_number": "435-218-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "TRAVELLER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-256-2823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.S. D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "6859851-1202",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "7218960-1202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthology Experts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.