THEODORE L. CONGER (NPI# 1588676738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588676738 |
| Entity Type | Individual |
| Full Name | THEODORE L. CONGER |
| Credential | D. C. |
| Practice Address |
747 E South Temple Ste 200 Salt Lake City UT 84102-1217 |
| Practice Telephone | 8015304802 |
| Mailing Telephone | 8015304802 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-05-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 171096-1202 | UT | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RR RETIREMENT | 350011548 | 01 |
| UT | MOLINA HEALTHCARE | TPRA10671 | 01 |
| UT | AETNA | 4550443 | 01 |
| UT | IHC HEALTH PLANS | 107000433103 | 01 |
| Street Address |
747 E SOUTH TEMPLE STE 200 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-1217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386859817 | Theodore L Conger D.c., Inc | Chiropractor | 747 E South Temple Ste 200, Salt Lake City, UT 84102-1217 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275098394 | Lindsay Kopp | Chiropractor | 1939 S 1100 E, Salt Lake City, UT 84106-3580 | 2019-02-02 |
| 1740744101 | Drd Enterprises, LLC | Chiropractor | 7186 S Highland Dr Ste 150, Salt Lake City, UT 84121-7324 | 2019-01-29 |
| 1093289795 | Matthew Kory Jackson | Chiropractor | 515 E 4500 S Ste G230, Salt Lake City, UT 84107-4510 | 2019-01-15 |
| 1386159663 | Mikel Roy | Chiropractor | 1860 S 300 W Ste B, Salt Lake City, UT 84115-2198 | 2017-12-07 |
| 1508302225 | Scott Graziosa | Chiropractor | 3160 E Coronet Dr, Salt Lake City, UT 84124-3107 | 2017-01-19 |
| 1245642966 | Yasa LLC | Chiropractor | 5882 S 900 E Ste 100, Salt Lake City, UT 84121-1684 | 2014-05-29 |
| 1962814392 | John Corbaley | Chiropractor | 370 E South Temple Ste 100, Salt Lake City, UT 84111-1240 | 2014-05-20 |
| 1790022382 | Bradley Alan Anderson | Chiropractor | 3980 S 700 E Ste 23, Salt Lake City, UT 84107-2530 | 2013-01-15 |
| 1316291966 | Mark Frogley | Chiropractor | 1264 W Village Main Dr, Suite A, Salt Lake City, UT 84119-3396 | 2012-11-05 |
| 1548513088 | Taylor Robert Krick | Chiropractor | 1860 S 300 W, Suite B, Salt Lake City, UT 84115-2085 | 2012-10-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
Please comment or provide details below to improve the information on THEODORE L. CONGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.