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DR. KEAGAN TICE SMALLWOOD DC
NPI 1639785173
Chiropractor in South Jordan, UT

Active since September 21, 2020Accepts Medicare Assignment
912 W BAXTER DR STE 130, SOUTH JORDAN, UT 84095(385) 308-4355 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Keagan Tice Smallwood Dc NPPES

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

DR. KEAGAN TICE SMALLWOOD DC (NPI 1639785173) is an individual chiropractor in South Jordan, Utah, licensed in Utah (123902991202) and active in the NPI registry since September 2020. He is a graduate of Other (2020).

NPPES Registry Identity

NPI1639785173
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. KEAGAN TICE SMALLWOODCredential: DC
Location Address912 W BAXTER DR STE 130South Jordan, UT 84095-5876
Mailing Address912 W Baxter Dr Ste 130South Jordan, UT 84095-5876 · (853) 084-3553
Phone(385) 308-4355
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 21, 2020
Last NPPES UpdateAugust 2, 2023
NPPES CertifiedAugust 2, 2023
✔ NPI 1639785173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Licenses✔ Licensed in UT · 123902991202✔ Licensed in TX · 14500
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.
912 W BAXTER DR STE 130, South Jordan, UT 84095
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, Molina Healthcare, Select Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Keagan Tice Smallwood Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880076744
PECOS Enrollment IDI20260408003456

Medicare Billing Reassignments

2

Medicare enrollment records show Keagan Smallwood reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vitality Health Regeneration Inc
170 mi
Sports Physician
383 N MAIN STREET, STE. 1
Thayne, WY 83127
  • Reassigned Medicare billing, Wyoming enrollment
  • 2 clinicians in this Medicare group
NPI 1467054262 (307) 883-4000
H & h Chiropractic, LLC
209 mi
Family Medicine
110 W 1325 N STE 150
Cedar City, UT 84721
  • Reassigned Medicare billing, Utah enrollment
  • 8 clinicians in this Medicare group
NPI 1356590319 (435) 867-6354

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 Keagan Smallwood's NPI number?

The NPI number for Keagan Smallwood is 1639785173. It was assigned to this individual provider in the NPPES registry on September 21, 2020.

Where is Keagan Smallwood located?

Keagan Smallwood practices at 912 W Baxter Dr Ste 130, South Jordan, UT 84095. The listed phone number is (385) 308-4355.

What is Keagan Smallwood's specialty?

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

Is Keagan Smallwood enrolled in Medicare?

Yes. Keagan Smallwood is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Keagan Smallwood's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keagan Smallwood reassigns Medicare benefits to 2 organizations: Vitality Health Regeneration Inc (Thayne, WY) and H & h Chiropractic, LLC (Cedar City, UT). Each 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 Keagan Smallwood's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keagan Smallwood accept?

Health plans from Blue Cross Blue Shield of Wyoming, Molina Healthcare, Select Health and University of Utah Health Plans list Keagan Smallwood 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 Keagan Smallwood was last updated on August 2, 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.