Individual provider Active NPI

Steven Charles Dewey, O.D.

  • Optometrist
  • Taylorsville, UT
National Provider Identifier
1063462810
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1132329934 Issued in UT
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, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
203606109016MedicaidUT
203606109024MedicaidUT

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
I20060626000179 UT Practitioner - Optometry 5799797221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1132329934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 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.

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

Verify at the official NPI Registry.