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

Active since September 21, 2020
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: August 02, 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.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Keagan Tice Smallwood Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880076744
PECOS Enrollment IDI20250910001417, I20260408003456

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 enrollment system.

What insurance does Keagan Smallwood accept?

Health plans from Blue Cross Blue Shield of Wyoming 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.