Active NPI
Steven Charles Dewey, O.D.
- Optometrist
- Taylorsville, UT
National Provider Identifier
1063462810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1132329934
- Practice address
- 5800 S Redwood Rd
Taylorsville, UT 84123-5327 - Phone
- (801) 964-1300
- Fax
- (801) 964-1300
- NPI assigned
- May 11, 2006
- Last updated
- Sep 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1132329934 | UT | Primary |
Addresses
Primary practice location
5800 S Redwood Rd
Taylorsville, UT 84123-5327
Mailing address
5800 S Redwood Rd
Taylorsville, UT 84123-5327
Phone (801) 964-1300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203606109016 | Medicaid | UT | |
| 203606109024 | Medicaid | UT |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1132329934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
Locations
1520 W 9000 S
Ste E
West Jordan, UT 84088
Phone (801) 561-7300
Networks
- UT PPO D-SNP
- UT PPO
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Shopko Optical 4097
- Eyewear Supplier
- West Valley City, UT
- NPI 1043876428
Optometrist
-
dba Fielmann Vision Care 4313
- Eyewear Supplier
- Rockford, IL
- NPI 1467311142
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410912000000",
"number": "1063462810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 S REDWOOD RD",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841235327",
"telephone_number": "801-964-1300",
"fax_number": "801-964-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 S REDWOOD RD",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841235327",
"telephone_number": "801-964-1300",
"fax_number": "801-964-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWEY",
"first_name": "STEVEN",
"middle_name": "CHARLES",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2014-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "1132329934",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203606109016",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203606109024",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.