Individual provider Active NPI

Lynn Rex Purcell, O.D.

  • Optometrist
  • Tremonton, UT
National Provider Identifier
1013910397
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
111108-9934 Issued in UT
Practice address
495 W 600 N
Tremonton, UT 84337-2411
Phone
(435) 257-7436
Fax
(435) 257-6229
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 111108-9934 UT Primary

Addresses

Primary practice location

495 W 600 N
Tremonton, UT 84337-2411

Mailing address

PO Box 155
Tremonton, UT 84337-0155
Phone (435) 257-7436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040218000015 UT Practitioner - Optometry 0244125318 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111108-9934UTMDOptometrist

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Bear River Eye Center, Inc Optometrist CurrentSince Feb 2, 1996 Accepting new patients
Mt Ogden Eye Center LLC Optometrist Past Accepting new patients

Locations

495 W 600 N
Tremonton, UT 84337
Phone (435) 257-7436

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • FHIR API: https://bearrivereye.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1013910397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843370155",
            "telephone_number": "435-257-7436",
            "fax_number": "435-257-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 W 600 N",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843372411",
            "telephone_number": "435-257-7436",
            "fax_number": "435-257-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "LYNN",
        "middle_name": "REX",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "111108-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tremonton, UT

Sources for this page

Verify at the official NPI Registry.