Misustin Chiropractic PC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

320260-1202 Issued in UT

Legal business name

MISUSTIN CHIROPRACTIC PC

Practice address

1415 N 400 E
Suite a
Logan, UT 84341-7539

Phone

(435) 753-2840

Fax

(435) 787-9422

NPI assigned

Dec 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Lawrence Misustin, D.C.NPI 1427115682

Title

Owner

Phone

(435) 753-2840

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peterson Chiropractic Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 7

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

• James Lawrence Misustin, D.C.

  • Sports Physician Chiropractor
  • Logan, UT
  • NPI 1427115682

  Sports Physician, UT

  Medicare reassignment Care Compare group NPD Authorized official
• Karson B. Johnson, D.C.

  • Chiropractor
  • North Logan, UT
  • NPI 1659406858

  UT

  Medicare reassignment Care Compare group
• Evan J Lefevre,, D.C., P.C.

  • Chiropractor
  • Logan, UT
  • NPI 1386725190

  UT

  Medicare reassignment Care Compare group
• Diane Kirby, LMT

  • Massage Therapist
  • Logan, UT
  • NPI 1275204216
  NPD
• Kimberly Lynn Tagg, FNP-BC

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1801477286
  NPD
• Brent E. Peterson, D.C.

  • Chiropractor
  • Logan, UT
  • NPI 1356535694
  NPD (past)
• Michael A Terry, D.C.

  • Chiropractor
  • Spokane, WA
  • NPI 1861550279
  NPD (past)

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1801070628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N 400 E",
            "address_2": "SUITE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417539",
            "telephone_number": "435-753-2840",
            "fax_number": "435-787-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N 400 E",
            "address_2": "SUITE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417539",
            "telephone_number": "435-753-2840",
            "fax_number": "435-787-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISUSTIN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "MISUSTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-753-2840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "UT",
            "license": "320260-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "554155506001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peterson Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Miller, RDN
• Karen Anne Miller, RN
• Cassie Milligan, FNP
• Mind, Body, Soul Chiropractic
• Kyle D Miskin
• James Lawrence Misustin, D.C.
• Karlie Mitchell
• Tim S. Mitchell, PH.D.
• Modern Care
• Monique Frazier, PH.D., P.C.

• All providers in Logan, UT
• Sports Physician Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.