Individual provider Active NPI

Kris Alfred Hill, OD

  • Optometrist
  • Midvale, UT
National Provider Identifier
1043228554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
109580-9934 Issued in UT
Practice address
7400 Union Park Ave
Suite 202
Midvale, UT 84047-6704
Phone
(801) 569-3698
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 109580-9934 UT Primary

Addresses

Primary practice location

7400 Union Park Ave
Suite 202
Midvale, UT 84047-6704

Mailing address

7400 Union Park Ave
Suite 202
Midvale, UT 84047-6704
Phone (801) 569-3698

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
I20031215000520 UT Practitioner - Optometry 9335044262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109580-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kris a Hill OD PC Optometrist CurrentSince Jul 1, 2005 Accepting new patients
Jed C Winder OD, PC Optometrist PastSince Jan 1, 2008 Accepting new patients

Locations

7400 S Union Park Ave
Ste 202
Midvale, UT 84047
Phone (801) 569-3698

300 S Main St
Tooele, UT 84074
Phone (435) 882-3233

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043228554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 UNION PARK AVE",
            "address_2": "SUITE 202",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840476704",
            "telephone_number": "801-569-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 UNION PARK AVE",
            "address_2": "SUITE 202",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840476704",
            "telephone_number": "801-569-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "KRIS",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "109580-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

Verify at the official NPI Registry.