Individual provider Active NPI

Jonathan Lee Caldwell, D.C.

  • Chiropractor
  • Enoch, UT
National Provider Identifier
1912209107
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5487543-1202 Issued in UT
Practice address
476 E Midvalley Rd Ste 1
Enoch, UT 84721-7674
Phone
(435) 865-0917
NPI assigned
Nov 22, 2010
Last updated
Oct 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5487543-1202 UT Primary

Addresses

Primary practice location

476 E Midvalley Rd Ste 1
Enoch, UT 84721-7674

Mailing address

476E Midvalley Rd
Cedar City, UT 84721-7603
Phone (435) 865-0917

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301000580 UT Practitioner - Chiropractic 4880875574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

476 E Midvalley Rd
Enoch, UT 84721-7603
Phone (435) 865-0917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5487543-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Enoch Family Chiropractic, PLLC CurrentSince Jan 3, 2011 Accepting new patients
Enoch Community Healthcare Past Accepting new patients

Locations

476 E Midvalley Rd
Enoch, UT 84721
Phone (435) 708-0400

476 E Midvalley Rd
Ste 1
Enoch, UT 84721
Phone (435) 865-0917

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1912209107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476E MIDVALLEY RD",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847217603",
            "telephone_number": "435-865-0917",
            "fax_number": "435-263-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 E MIDVALLEY RD STE 1",
            "city": "ENOCH",
            "state": "UT",
            "postal_code": "847217674",
            "telephone_number": "435-865-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5487543-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enoch, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; 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.