Utah Vision Development Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

7383319-9934 Issued in UT

Legal business name

UTAH VISION DEVELOPMENT CENTER, LLC

Practice address

3672 W South Jordan Pkwy
Ste 103
South Jordan, UT 84009-7171

Phone

(801) 810-1060

NPI assigned

Feb 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jarrod Davies, ODNPI 1861621864

Title

Optometrist

Phone

(801) 810-1060

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 3

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

• Jarrod Davies, O.D.

  • Optometrist
  • South Jordan, UT
  • NPI 1861621864
  Medicare reassignment Care Compare group NPD Authorized official
• Thomas Edward Clark, OD

  • Optometrist
  • South Jordan, UT
  • NPI 1669096020
  Medicare reassignment Care Compare group NPD
• Stephanie Fine

  • Surgery Physician
  • Albuquerque, NM
  • NPI 1922008622
  NPD (past)

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1104123801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3672 W SOUTH JORDAN PKWY",
            "address_2": "STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097171",
            "telephone_number": "801-810-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3672 W SOUTH JORDAN PKWY",
            "address_2": "STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097171",
            "telephone_number": "801-810-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH VISION DEVELOPMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "JARROD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "801-810-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "7383319-9934",
            "primary": true
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "UT",
            "license": "7383319-9934",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "UT",
            "license": "7383319-9934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Utah Center for Sleep Apnea & TMJ
• Utah CVS Pharmacy LLC
• Utah CVS Pharmacy, L.L.C.
• Utah Facial & Oral Surgery
• Utah Pain Relief Institute South, LLC
• Utah Wellness Solutions
• Utopia Family Services
• Rachot K Vacharothone, MD
• Edward Douglas Vaka'Uta, LCSW
• Echo Valbuena, LCSW

• Optometrist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.