Red Butte Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

159542-1202 Issued in UT

Legal business name

RED BUTTE CHIROPRACTIC CLINIC

Practice address

525 E 100 S Ste 420
Salt Lake City, UT 84102-2072

Phone

(801) 322-3067

Fax

(801) 322-4054

NPI assigned

Dec 14, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Michael Conrad Lane, D.C.

Title

Chiropractor

Phone

(801) 322-3067

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1881963262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 S 2500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841083049",
            "telephone_number": "801-322-3067",
            "fax_number": "801-322-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 100 S STE 420",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022072",
            "telephone_number": "801-322-3067",
            "fax_number": "801-322-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BUTTE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CONRAD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "801-322-3067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "159542-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.