Individual provider Active NPI

Tyler R Elmore, DC

  • Chiropractor
  • Syracuse, UT
National Provider Identifier
1811081771
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4797992-1202 Issued in UT
Practice address
1013 W 2700 S
Syracuse, UT 84075
Phone
(801) 774-7540
Fax
(801) 774-7542
NPI assigned
Oct 3, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4797992-1202 UT Primary

Addresses

Primary practice location

1013 W 2700 S
Syracuse, UT 84075

Mailing address

1013 W 2700 S
Syracuse, UT 84075
Phone (801) 774-7540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070928000379 UT Practitioner - Chiropractic 7012002546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1013 W 2700
Syracuse, UT 84075-8973
Phone (801) 774-7540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4797992-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Chiropractic and Health Center LC Chiropractor CurrentSince Oct 15, 2007 Accepting new patients
Elmore Chiropractic & Nutrition, LC Chiropractor Past Accepting new patients
North Ogden Chiropractic & Wellness, L.L.C. PastSince Aug 21, 2008 Accepting new patients

Locations

1013 W 2700 S
Syracuse, UT 84075
Phone (801) 613-8842

1747 Heritage Ln
Ste B105
Syracuse, UT 84075
Phone (801) 774-7540

1842 S 2000 W
Ste 2
Syracuse, UT 84075
Phone (801) 774-7540

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1811081771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 W 2700 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-774-7540",
            "fax_number": "801-774-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W 2700 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-774-7540",
            "fax_number": "801-774-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "TYLER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "4797992-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.