NPIMap

Organization Active NPI

Promontory Vision Partners

Doing business as Clinton Family Vision

  • Optometrist
  • Clinton, UT
National Provider Identifier
1013187822
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5704014-9934 Issued in UT
Legal business name
PROMONTORY VISION PARTNERS
Doing business as
Clinton Family Vision
Practice address
1448 N 2000 W
Suite 12
Clinton, UT 84015-8377
Phone
(801) 779-0708
NPI assigned
Mar 7, 2008
Last updated
Dec 14, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PROMONTORY VISION PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Clark Fielden, O.D.NPI 1457339285
Title
President
Phone
(801) 779-0708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5704014-9934 UT Primary

Addresses

Primary practice location

1448 N 2000 W
Suite 12
Clinton, UT 84015-8377

Mailing address

1448 N 2000 W
#3
Clinton, UT 84015-8377
Phone (801) 779-0708

Other names 1

  • Clinton Family Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081030000086 UT Part B Supplier - Clinic/Group Practice 3375602790 Receives reassigned benefits from 6 practitioners
Practice locations: Clinton, UT

National Provider Directory

National Provider Directory
Part of
Promontory Vision Partners

Locations

2028 W 2220 N
Clinton, UT 84015
Phone (801) 779-0708

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1013187822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 N 2000 W",
            "address_2": "#3",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840158377",
            "telephone_number": "801-779-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 N 2000 W",
            "address_2": "SUITE 12",
            "city": "CLINTON",
            "state": "UT",
            "postal_code": "840158377",
            "telephone_number": "801-779-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMONTORY VISION PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMONTORY VISION PARTNERS",
        "enumeration_date": "2008-03-07",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "FIELDEN",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-779-0708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5704014-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.