STOCKWELL SPINAL CARE, LLC (NPI# 1427687854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427687854 |
| Entity Type | Organization |
| Organization Name | STOCKWELL SPINAL CARE, LLC |
| Practice Address |
11585 S State St Ste 102 Draper UT 84020-7401 |
| Mailing Address |
1640 E 11245 S Sandy UT 84092-5137 |
| Practice Telephone | 8017012111 |
| Mailing Telephone | 8017393370 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Authorized Official Name | JOSHUA H. STOCKWELL (MANAGER) |
| Authorized Official Telephone | 8017393370 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Draper Spinal Care | Doing Business As Name - Organization |
| Street Address |
11585 S STATE ST STE 102 |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-7401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| 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 |
|---|---|---|---|---|
| 1194061713 | Craig Richard Dawson | Chiropractor | 11620 S State St Ste 1401, Draper, UT 84020-7124 | 2012-12-31 |
| 1740588441 | Corner Canyon Chiropractic | Chiropractor | 1136 Draper Pkwy, Draper, UT 84020-9095 | 2011-03-03 |
| 1508192311 | Kimberly Kercher Glasgow | Chiropractor | 866 E 12300 S Ste C, Draper, UT 84020-5018 | 2009-10-29 |
| 1770715831 | Carl Gordon Lesueur II | Chiropractor | 1178 Draper Pkwy, Draper, UT 84020 | 2009-08-21 |
| 1134363351 | Gregory Shaun Reynolds | Chiropractor | 826 E 12300 S Ste 4b, Draper, UT 84020-8276 | 2009-05-01 |
| 1528219060 | Dr Brian Muto Enterprises | Chiropractor | 11483 S State St, Suite F, Draper, UT 84020-9403 | 2008-10-02 |
| 1689835167 | Mark Vosti | Chiropractor | 1101 E Draper Pkwy, Draper, UT 84020-9096 | 2008-06-18 |
| 1861662983 | Ginger Heinitz | Chiropractor | 1178 E Draper Pkwy, Draper, UT 84020-9095 | 2008-03-04 |
| 1285838524 | Maple Ridge Health Systems | Chiropractor | 11483 South State St., Suite F, Draper, UT 84020 | 2007-06-12 |
| 1619178647 | Humble Finsand | Chiropractor | 12227 S Business Park Dr, Ste 115, Draper, UT 84020-8191 | 2007-05-29 |
| Find all providers in DRAPER | ||||
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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.