Organization Active NPI

Robert K. Nelson D.C., P.C.

  • Chiropractor
  • Vernal, UT
National Provider Identifier
1992900237
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
171551-1202 Issued in UT
Legal business name
ROBERT K. NELSON D.C., P.C.
Practice address
756 W Main St
Vernal, UT 84078-2410
Phone
(435) 781-0048
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Robert K NelsonNPI 1447206586
Title
President
Phone
(435) 781-0048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 171551-1202 UT Primary

Addresses

Primary practice location

756 W Main St
Vernal, UT 84078-2410

Mailing address

756 W Main St
Vernal, UT 84078-2410
Phone (435) 781-0048

Other identifiers 1

IdentifierTypeStateIssuer
528729162002MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000530 UT Part B Supplier - Clinic/Group Practice 1052499852 Receives reassigned benefits from 1 practitioner
Practice locations: Vernal, UT

National Provider Directory

National Provider Directory

Locations

756 W Main St
Vernal, UT 84078
Phone (435) 781-0048

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1992900237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 W MAIN ST",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782410",
            "telephone_number": "435-781-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 W MAIN ST",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782410",
            "telephone_number": "435-781-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT K. NELSON D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-781-0048"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "171551-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528729162002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.