Individual provider Active NPI

John Joseph Colarusso, D.C.

  • Chiropractor
  • Riverton, UT
National Provider Identifier
1891860789
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5072634-1202 Issued in UT
Practice address
12571 S Pasture Road
Suite E
Riverton, UT 84096-7037
Phone
(801) 878-3645
Fax
(801) 878-3647
NPI assigned
Nov 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5072634-1202 UT Primary

Addresses

Primary practice location

12571 S Pasture Road
Suite E
Riverton, UT 84096-7037

Mailing address

12571 S Pasture Road
Suite E
Riverton, UT 84096-7037
Phone (801) 878-3645

Other identifiers 1

IdentifierTypeStateIssuer
000061848OtherUTMEDICARE GROUP PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000828 UT Practitioner - Chiropractic 4981590080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12571 S Pasture Rd
Suite E
Riverton, UT 84096-4814
Phone (801) 878-3645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Colarusso Family Chiropractic, PC Chiropractor CurrentSince Oct 15, 2007 Accepting new patients
Peterson Chiropractic Chiropractor Past Accepting new patients
Peterson Chiropractic Inc Chiropractor PastSince Aug 12, 1991 Accepting new patients

Locations

12571 S Pasture Rd
Riverton, UT 84096

12571 S Pasture Rd
Ste E
Riverton, UT 84096
Phone (801) 878-3645

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1891860789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12571 S PASTURE ROAD",
            "address_2": "SUITE E",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967037",
            "telephone_number": "801-878-3645",
            "fax_number": "801-878-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12571 S PASTURE ROAD",
            "address_2": "SUITE E",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967037",
            "telephone_number": "801-878-3645",
            "fax_number": "801-878-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLARUSSO",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-23",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5072634-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "000061848",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.