Individual provider Active NPI

Dallas S George, D.C.

  • Chiropractor
  • Bountiful, UT
National Provider Identifier
1861639163
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
72128261202 Issued in UT
Practice address
395 N 200 W
Bountiful, UT 84010-7045
Phone
(801) 295-6667
Fax
(801) 295-6664
NPI assigned
Jan 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 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 72128261202 UT Primary

Addresses

Primary practice location

395 N 200 W
Bountiful, UT 84010-7045

Mailing address

296 W 2350 S
Bountiful, UT 84010-7630
Phone (801) 635-8029

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000726 UT Practitioner - Chiropractic 3072679349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Chiropractic IncGroup PAC ID 1254512676, 2 clinicians

Practice addresses (Care Compare)

395 N 200
Bountiful, UT 84010-7045
Phone (801) 295-6667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72128261202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Chiropractic Inc Chiropractor CurrentSince Mar 1, 2011 Accepting new patients
Peak Wellness Inc Chiropractor PastSince Mar 1, 2011 Accepting new patients

Locations

395 N 200 W
Bountiful, UT 84010
Phone (801) 295-6667

Interoperability endpoints

  • Direct secure messaging: drd@ccg0001.direct.chirotouch.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1861639163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 W 2350 S",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107630",
            "telephone_number": "801-635-8029",
            "fax_number": "801-860-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N 200 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107045",
            "telephone_number": "801-295-6667",
            "fax_number": "801-295-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "DALLAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "72128261202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.