Active NPI
Shanon Nelson, D.C.
- Chiropractor
- Draper, UT
National Provider Identifier
1811961089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 51456731202
- Practice address
- 12176 S 1000 E
Draper, UT 84020-9716 - Phone
- (801) 523-2233
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 51456731202 | UT | Primary |
Addresses
Primary practice location
12176 S 1000 E
Draper, UT 84020-9716
Mailing address
594 Treven PL
Draper, UT 84020-7656
Phone (801) 523-2232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870395551005 | Medicaid | UT |
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 |
|---|---|---|---|
| 51456731202 | UT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811961089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "594 TREVEN PL",
"city": "DRAPER",
"state": "UT",
"postal_code": "840207656",
"telephone_number": "801-523-2232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12176 S 1000 E",
"city": "DRAPER",
"state": "UT",
"postal_code": "840209716",
"telephone_number": "801-523-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "SHANON",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "UT",
"license": "51456731202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "870395551005",
"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 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.