NPIMap

Organization Active NPI

Confederated Tribes of the Goshute Indian Reservation

Doing business as Sacred Circle Healthcare

  • Optometrist
  • SLC, UT
National Provider Identifier
1023730413
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CONFEDERATED TRIBES OF THE GOSHUTE INDIAN RESERVATION
Doing business as
Sacred Circle Healthcare
Practice address
660 S 200 E Ste 250
SLC, UT 84111-3846
Phone
(801) 359-2256
NPI assigned
Sep 13, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Crystal Contreras
Title
Billing Manager
Phone
(801) 359-2256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

660 S 200 E Ste 250
SLC, UT 84111-3846

Mailing address

660 S 200 E Ste 250
SLC, UT 84111-3846

Other identifiers 1

IdentifierTypeStateIssuer
461840OtherMEDICARE A

Other names 1

  • Sacred Circle Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sacred Circle Healthcare14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1023730413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841113846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES OF THE GOSHUTE INDIAN RESERVATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "801-359-2256"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A",
            "identifier": "461840",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Circle Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.