NPIMap

Organization Active NPI

Frank a Siddoway OD PC

  • Optometrist
  • Provo, UT
National Provider Identifier
1073786505
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1125699934 Issued in UT
Legal business name
FRANK A SIDDOWAY OD PC
Practice address
1675 N 200 W
#11-A
Provo, UT 84604-2540
Phone
(801) 374-2227
Fax
(801) 374-5197
NPI assigned
Apr 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Frank A Siddoway, OD
Title
Doctor
Phone
(801) 374-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1125699934 UT Primary

Addresses

Primary practice location

1675 N 200 W
#11-A
Provo, UT 84604-2540

Mailing address

1675 N 200 W
#11-A
Provo, UT 84604-2540
Phone (801) 374-2227

Other identifiers 1

IdentifierTypeStateIssuer
529902626008MedicaidUT

National Provider Directory

National Provider Directory

Locations

1675 N 200 W
Ste 11A
Provo, UT 84604
Phone (801) 374-2227

374 E 400 S
Springville, UT 84663
Phone (801) 489-5111

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1073786505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N 200 W",
            "address_2": "#11-A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-374-2227",
            "fax_number": "801-374-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N 200 W",
            "address_2": "#11-A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-374-2227",
            "fax_number": "801-374-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANK A SIDDOWAY OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "SIDDOWAY",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "801-374-2227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1125699934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529902626008",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.