GREAT BASIN SPINE AND SPORTS (NPI# 1639485014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639485014 |
| Entity Type | Organization |
| Organization Name | GREAT BASIN SPINE AND SPORTS |
| Practice Address |
134 E 4600 S Washington Terrace UT 84405-5946 |
| Practice Telephone | 8016272023 |
| Mailing Telephone | 8016272023 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-12-28 |
| Authorized Official Name | MICHAEL GREGORY GRAVES (SINGLE MEMBER) |
| Authorized Official Telephone | 8016272023 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 7617785-1202 | UT | Chiropractic Providers |
| Street Address |
134 E 4600 S |
| City | WASHINGTON TERRACE |
| State | UT |
| Zip Code | 84405-5946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427293695 | Ogden Family Chiropractic LLC | Clinic/Center | 134 E 4600 S, Washington Terrace, UT 84405-5946 | 2008-12-02 |
| 1932412012 | Michael Gregory Graves | Chiropractor | 134 E 4600 S, Washington Terrace, UT 84405-5946 | 2010-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| 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 |
|---|---|---|---|---|
| 1245417773 | Blake Fenton | Chiropractor | 146 E 4600 S, Washington Terrace, UT 84405-5946 | 2008-01-28 |
| 1932412012 | Michael Gregory Graves | Chiropractor | 134 E 4600 S, Washington Terrace, UT 84405-5946 | 2010-07-19 |
| 1053586131 | Adjust Your Life - Chiropractic | Chiropractor | 146 E 4600 S, Washington Terrace, UT 84405-5946 | 2008-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972412 | Lindsay June Hall | Chiropractor | 613 E Fort Union Blvd, Midvale, UT 84047-5531 | 2020-11-06 |
| 1437758968 | Jonathan Porter | Chiropractor | 6243 S Redwood Rd Ste 230, Taylorsville, UT 84123-6410 | 2020-10-26 |
| 1114525748 | Ryan Scott Clark | Chiropractor | 1416 N Redwood Rd Ste B, Saratoga Springs, UT 84045-6455 | 2020-10-15 |
| 1588262430 | Crux Sport & Spine | Chiropractor | 922 E Brigham Rd Bldg 5c, St George, UT 84790-8751 | 2020-10-13 |
| 1184230385 | Shelton Chiropractic | Chiropractor | 428 N State Road 198 Ste B, Salem, UT 84653-4605 | 2020-09-22 |
| 1104430388 | Saratoga Chiropractic | Chiropractor | 1305 N Commerce Dr Ste 200, Saratoga Springs, UT 84045-5310 | 2020-09-03 |
| 1982218442 | Draney Chiropractic | Chiropractor | 7613 S Jordan Landing Blvd Ste 120, West Jordan, UT 84084-1973 | 2020-09-02 |
| 1770191694 | Elevate Functional Health, LLC | Chiropractor | 667 Sweetspring Dr, Santa Clara, UT 84765-5469 | 2020-07-16 |
| 1730707043 | Brennan Fife Bushman | Chiropractor | 2464 W 12600 S Ste 100, Riverton, UT 84065-7274 | 2020-07-13 |
| 1659998474 | Michael Alan Alsop | Chiropractor | 1910 N 135 W, Orem, UT 84057-2103 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | WASHINGTON TERRACE |
| Zip Code | 84405 |
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| 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.