Active NPI
Donald Everett Vradenburg, D.C.
- Internist Chiropractor
- St George, UT
National Provider Identifier
1790801256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- 176130-1202
- Practice address
- 321 N Mall Dr
Suite I 201
St George, UT 84790-7302 - Phone
- (435) 574-2995
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 176130-1202 | UT | Primary |
Addresses
Primary practice location
321 N Mall Dr
Suite I 201
St George, UT 84790-7302
Mailing address
321 N Mall Dr
Suite I 201
St George, UT 84790-7302
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
| License | State | Type | Specialty |
|---|---|---|---|
| 176130-1202 | UT | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790801256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 N MALL DR",
"address_2": "SUITE I 201",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847907302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 N MALL DR",
"address_2": "SUITE I 201",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847907302",
"telephone_number": "435-574-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VRADENBURG",
"first_name": "DONALD",
"middle_name": "EVERETT",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "UT",
"license": "176130-1202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.