Individual provider Active NPI

Perry James Lofthouse, D.C.

  • Chiropractor
  • Bountiful, UT
National Provider Identifier
1770594228
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
170238-1202 Issued in UT
Practice address
1355 N Main St
Suite 6
Bountiful, UT 84010-5981
Phone
(801) 298-9190
Fax
(801) 298-2451
NPI assigned
Aug 10, 2006
Last updated
Aug 20, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 170238-1202 UT Primary

Addresses

Primary practice location

1355 N Main St
Suite 6
Bountiful, UT 84010-5981

Mailing address

1355 North Main
Suite 6
Bountiful, UT 84010
Phone (801) 298-9190

Other identifiers 4

IdentifierTypeStateIssuer
56105OtherUTDESERET MUTUAL BENEFIT AD
XXXXXXXOtherUTUNITED HEALTH CARE
8812OtherUTPUBLIC EMPLOYEE HEALTH PL
107000139101OtherUTSELECT HEALTH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
170238-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bountiful Vision Plaza PC CurrentSince Sep 20, 2017 Accepting new patients

Locations

311 E 500 S
Bountiful, UT 84010
Phone (801) 295-4441

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1770594228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 NORTH MAIN",
            "address_2": "SUITE 6",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-298-9190",
            "fax_number": "801-298-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N MAIN ST",
            "address_2": "SUITE 6",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840105981",
            "telephone_number": "801-298-9190",
            "fax_number": "801-298-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTHOUSE",
        "first_name": "PERRY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "170238-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL BENEFIT AD",
            "identifier": "56105",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "XXXXXXX",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC EMPLOYEE HEALTH PL",
            "identifier": "8812",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "107000139101",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.