Individual provider Active NPI

Russell Val Harward Sr., DC

  • Chiropractor
  • Draper, UT
National Provider Identifier
1790739324
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
172703-1202 Issued in UT
Practice address
11616 S State St
Suite 1502
Draper, UT 84020-7125
Phone
(801) 571-2200
Fax
(801) 816-1048
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 172703-1202 UT Primary

Addresses

Primary practice location

11616 S State St
Suite 1502
Draper, UT 84020-7125

Mailing address

11616 S State St
Suite 1502
Draper, UT 84020-7125
Phone (801) 571-2200

Other identifiers 6

IdentifierTypeStateIssuer
870560087OtherUTSELECTHEALTH
DE0098OtherUTPALMETTO GBA - RAILROAD
0004464362OtherUTAETNA
870560087OtherUTUNITED HEALTH CARE
870560087OtherUTMAIL HANDLERS
870560087-001OtherUTMBA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000400 UT Practitioner - Chiropractic 2860423332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11616 S State St
Suite 1502
Draper, UT 84020-7125
Phone (801) 571-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
172703-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
RVH Incorporated CurrentSince Dec 10, 2002 Accepting new patients

Locations

11616 S State St
Ste 1502
Draper, UT 84020
Phone (801) 571-2200

9860 S 700 E
Ste 10
Sandy, UT 84070
Phone (801) 571-2200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1790739324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11616 S STATE ST",
            "address_2": "SUITE 1502",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207125",
            "telephone_number": "801-571-2200",
            "fax_number": "801-816-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 S STATE ST",
            "address_2": "SUITE 1502",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207125",
            "telephone_number": "801-571-2200",
            "fax_number": "801-816-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARWARD",
        "first_name": "RUSSELL",
        "middle_name": "VAL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "172703-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTHEALTH",
            "identifier": "870560087",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD",
            "identifier": "DE0098",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004464362",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "870560087",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "870560087",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBA",
            "identifier": "870560087-001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.