Roy Raymond Gibson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1130289934 Issued in UT

Practice address

4949 S 900 W
Riverdale, UT 84405-3777

Phone

(801) 621-0480

Fax

(801) 612-3485

NPI assigned

Oct 25, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Pros of Layton LLCGroup PAC ID 1355680851, 4 clinicians

Eye Pros of OgdenGroup PAC ID 6901142025, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

Interoperability endpoints

• Direct secure messaging: roy.gibson@direct.revolutionehr.com

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.

• Eye Pros of Layton LLC

  dba Eye Pros

  • Optometrist
  • Layton, UT
  • NPI 1760956221
  Medicare reassignment Care Compare group NPD
• Eye Pros of Ogden

  dba Eye Pros

  • Optometrist
  • Riverdale, UT
  • NPI 1710456975
  Medicare reassignment Care Compare group NPD
• Eye Pros of Logan LLC

  dba Eye Pros

  • Optometrist
  • Logan, UT
  • NPI 1043702046
  Medicare reassignment NPD
• Dr Roy R Gibson & Associates Optometrists P C

  • Optometrist
  • Roy, UT
  • NPI 1659557528
  Authorized official Same address or phone

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104816743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 S 3750 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840678161",
            "telephone_number": "801-985-4141",
            "fax_number": "801-985-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 S 900 W",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053777",
            "telephone_number": "801-621-0480",
            "fax_number": "801-612-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "ROY",
        "middle_name": "RAYMOND",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1130289934",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1130288904",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "81820",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "589803",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11445324",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "1737499",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyecare Wellness Clinic P.L.L.C.
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• Amber Gentry
• Adrienne Glahe
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• Tawnya Gonzales
• Alex Goodrich
• Adrian Shaniece Green

• Optometrist in Riverdale, UT
• Providers in Riverdale, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.