Individual provider Active NPI

Gary B Davis, D.C.

  • Chiropractor
  • Salt Lake City, UT
National Provider Identifier
1831255736
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
176215-1202 Issued in UT
Practice address
716 E. 4500 South
Ste. N250
Salt Lake City, UT 84107
Phone
(801) 262-8400
Fax
(801) 262-5570
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 176215-1202 UT Primary

Addresses

Primary practice location

716 E. 4500 South
Ste. N250
Salt Lake City, UT 84107

Mailing address

716 E. 4500 South
Ste. N250
Salt Lake City, UT 84107
Phone (801) 262-8400

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

LicenseStateTypeSpecialty
176215-1202UTMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1831255736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E. 4500 SOUTH",
            "address_2": "STE. N250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-262-8400",
            "fax_number": "801-262-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E. 4500 SOUTH",
            "address_2": "STE. N250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-262-8400",
            "fax_number": "801-262-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GARY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "176215-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.