Organization Active NPI

St George Eye Center

  • Ophthalmology Physician
  • St George, UT
National Provider Identifier
1073996344
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6160962-1205 Issued in UT
Legal business name
ST GEORGE EYE CENTER
Practice address
617 E Riverside Dr Suite 101
St George, UT 84790
Phone
(435) 628-4507
Fax
(435) 628-3748
NPI assigned
Jul 6, 2015
Organization subpart
Yes
Parent organization
ST GEORGE EYE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Jason W Hendrix, MDNPI 1831117167
Title
Managing Member
Phone
(435) 628-4507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 375881-9934 UT
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 6160962-1205 UT Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 7154752-1205 UT

Addresses

Primary practice location

617 E Riverside Dr Suite 101
St George, UT 84790

Mailing address

617 E Riverside Dr Ste 101
Saint George, UT 84790-8720
Phone (435) 628-4507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150825003368 UT Part B Supplier - Clinic/Group Practice 9234445065 Receives reassigned benefits from 9 practitioners
Practice locations: St George, UT
O20160205002005 NV Part B Supplier - Clinic/Group Practice 9234445065 Receives reassigned benefits from 3 practitioners
Practice locations: Mesquite, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2146502St George Eye Center617 E Riverside Dr, Suite 101, St George, UT 84790Certificate of waiverMar 29, 2028

National Provider Directory

National Provider Directory
Part of
St George Eye Center LLC

Locations

340 Falcon Ridge Pkwy
Ste 104
Mesquite, NV 89027
Phone (702) 346-1131

340 Falcon Ridge Pkwy
Ste 400
Mesquite, NV 89027
Phone (435) 628-4507

48 S 2500 W
Hurricane, UT 84737
Phone (435) 236-3177

48 S 2500 W
Ste 200
Hurricane, UT 84737

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1073996344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 101",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847908720",
            "telephone_number": "435-628-4507",
            "fax_number": "435-628-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR SUITE 101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-628-4507",
            "fax_number": "435-628-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE EYE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST GEORGE EYE CENTER",
        "enumeration_date": "2015-07-06",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "435-628-4507",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "375881-9934",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "6160962-1205",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "7154752-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.