NPIMap

Organization Active NPI

Conklin Eyecare PLLC.

  • Optometrist
  • Salt Lake City, UT
National Provider Identifier
1174622922
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
53544129934 Issued in UT
Legal business name
CONKLIN EYECARE PLLC.
Practice address
350 Hope Ave
Salt Lake City, UT 84115-5116
Phone
(801) 484-8662
Fax
(801) 484-8664
NPI assigned
Sep 21, 2006
Last updated
Jul 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Dr. Michael Conklin, O.D.NPI 1013015650
Title
Owner
Phone
(801) 502-7394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 53544129934 UT Primary

Addresses

Primary practice location

350 Hope Ave
Salt Lake City, UT 84115-5116

Mailing address

350 Hope Ave
Salt Lake City, UT 84115-5116
Phone (801) 484-8662

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1174622922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOPE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155116",
            "telephone_number": "801-484-8662",
            "fax_number": "801-484-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HOPE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155116",
            "telephone_number": "801-484-8662",
            "fax_number": "801-484-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONKLIN EYECARE PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-502-7394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "53544129934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.