NPIMap

Organization Active NPI

Advanced Vision & Wellness Clinic

  • Optometrist
  • Ogden, UT
National Provider Identifier
1043633480
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
56760929934 Issued in UT
Legal business name
ADVANCED VISION & WELLNESS CLINIC
Practice address
298 24TH St
Suite 315
Ogden, UT 84401-1431
Phone
(801) 393-4413
NPI assigned
Jan 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Authorized official

Name
Dr. David Boyle Burnett, O.D.
Title
Manager
Phone
(801) 393-4413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 56760929934 UT Primary

Addresses

Primary practice location

298 24TH St
Suite 315
Ogden, UT 84401-1431

Mailing address

298 24TH St
Suite 315
Ogden, UT 84401-1431
Phone (801) 393-4413

National Provider Directory

National Provider Directory

Locations

298 24th St
Ste 315
Ogden, UT 84401
Phone (801) 393-4413

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1043633480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 24TH ST",
            "address_2": "SUITE 315",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011431",
            "telephone_number": "801-393-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 24TH ST",
            "address_2": "SUITE 315",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011431",
            "telephone_number": "801-393-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISION & WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BOYLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-393-4413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "56760929934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.