SPORTS CHIROPRACTIC OF UTAH LLC
NPI 1104372184
Chiropractor in Midvale, UT

Q: What is Sports Chiropractic Of Utah LLC's NPI number?

The NPI number for Sports Chiropractic Of Utah LLC is 1104372184. It was assigned to this organization in the NPPES registry on August 30, 2016.

Q: What is Sports Chiropractic Of Utah LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since August 30, 2016

6717 S 900 E STE 101, MIDVALE, UT 84047(406) 381-7577 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 24, 2023, Aug 30, 2016 (2 updates tracked since 2016).

On this page

About Sports Chiropractic Of Utah Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPORTS CHIROPRACTIC OF UTAH LLC (NPI 1104372184) is a healthcare organization registered as a chiropractor in Midvale, Utah and active in the NPI registry since August 2016. The organization lists Jordan Mousley, Owner, as its authorized official.

NPPES Registry Identity

NPI1104372184

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameSPORTS CHIROPRACTIC OF UTAH LLC

Location Address6717 S 900 E STE 101Midvale, UT 84047-5755

Mailing Address6717 S 900 E Ste 101Midvale, UT 84047-5755 · (406) 381-7577

Phone(406) 381-7577

Organization SubpartNo

Authorized OfficialJordan MousleyOwner · (406) 381-7577

Enumeration DateAugust 30, 2016

Last NPPES UpdateMarch 24, 20232 updates tracked since enumeration

NPPES CertifiedMarch 24, 2023

✔ NPI 1104372184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

Definition

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.

6717 S 900 E STE 101, Midvale, UT 84047

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sports Chiropractic Of Utah Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sports Chiropractic Of Utah LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jordan Mousley, D.C.

Chiropractic

NPI 1013465632

6717 S 900 E STE 101
Midvale, UT 84047

(801) 432-7511

✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sports Chiropractic Of Utah LLC's NPI number?

The NPI number for Sports Chiropractic Of Utah LLC is 1104372184. It was assigned to this organization in the NPPES registry on August 30, 2016.

Where is Sports Chiropractic Of Utah LLC located?

Sports Chiropractic Of Utah LLC is located at 6717 S 900 E Ste 101, Midvale, UT 84047. The listed phone number is (406) 381-7577.

What is Sports Chiropractic Of Utah LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Sports Chiropractic Of Utah LLC enrolled in Medicare?

Yes. Sports Chiropractic Of Utah LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sports Chiropractic Of Utah LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Sports Chiropractic Of Utah LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Sports Chiropractic Of Utah LLC accept?

Health plans from University of Utah Health Plans list Sports Chiropractic Of Utah LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sports Chiropractic Of Utah LLC was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.