Active NPI
Paul A. Paxman, OD
- Optometrist
- American Fork, UT
National Provider Identifier
1124097068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 114252-9934
- Practice address
- 24 W Main St
American Fork, UT 84003-2318 - Phone
- (801) 756-7996
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 114252-9934 | UT | Primary |
Addresses
Primary practice location
24 W Main St
American Fork, UT 84003-2318
Mailing address
24 W Main St
American Fork, UT 84003-2318
Phone (801) 756-7996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114252-9934 | UT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1124097068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 W MAIN ST",
"city": "AMERICAN FORK",
"state": "UT",
"postal_code": "840032318",
"telephone_number": "801-756-7996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 W MAIN ST",
"city": "AMERICAN FORK",
"state": "UT",
"postal_code": "840032318",
"telephone_number": "801-756-7996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAXMAN",
"first_name": "PAUL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "114252-9934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in American Fork, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.