Organization Active NPI

Cedar Valley Eyecare, LLC

  • Optometrist
  • Eagle Mountain, UT
National Provider Identifier
1104798735
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CEDAR VALLEY EYECARE, LLC
Practice address
4317 N Pony Express Pkwy
Eagle Mountain, UT 84005-1230
Phone
(801) 768-4100
Fax
(801) 768-0600
NPI assigned
Sep 23, 2025
Last updated
Jun 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Dr. Collin Gray, ODNPI 1881217446
Title
Optometrist
Phone
(801) 473-5127

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 1

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

Addresses

Primary practice location

4317 N Pony Express Pkwy
Eagle Mountain, UT 84005-1230

Mailing address

4317 N Pony Express Pkwy
Eagle Mountain, UT 84005-1230
Phone (801) 768-4100

National Provider Directory

National Provider Directory

Locations

4317 N Pony Express Pkwy
Eagle Mountain, UT 84005
Phone (801) 768-4100

Practitioners & affiliated clinicians

Practitioners 1

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": "1758585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1104798735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 N PONY EXPRESS PKWY",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840051230",
            "telephone_number": "801-768-4100",
            "fax_number": "801-768-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 N PONY EXPRESS PKWY",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840051230",
            "telephone_number": "801-768-4100",
            "fax_number": "801-768-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR VALLEY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-23",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "801-473-5127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.