CMS-1500 Box 24J / 33a • NPI
1124278817
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
111NN1001X (CMS 35)
Licensed & Credentialed Chiropractic Providers — Chiropractor, Nutrition
Box 32 Service Location & ZIP+4
1275 RED MOUNTAIN CIR, IVINS, UT, 84738-6178
✓ 9-Digit EDI 837 ZIP+4 (84738-6178)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1124278817 (BRADLEY GLEN CRUMP, DC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1124278817 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | BRADLEY GLEN CRUMP, DC |
| Plain-English Specialty | Licensed & Credentialed Chiropractic Providers — Chiropractor, Nutrition NUCC Code: 111NN1001X (Chiropractor, Nutrition) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 1275 RED MOUNTAIN CIR, IVINS, UT, 84738-6178 |
| Practice Telephone / Fax | Tel: (435) 668-2732 |
| Administrative Mailing Address | 2571 E 10 N, ST GEORGE, UT, 84790-2535 |
| Enumeration & Last Sync | Enumerated: 2008-09-30 | CMS Record Updated: 2008-09-30 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (111NN1001X)
What Does Taxonomy Code 111NN1001X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111NN1001X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor, Nutrition"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BRADLEY GLEN CRUMP, DC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111NN1001X — Chiropractor, NutritionPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Nutrition | State: UT | License: 363699-1202 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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