Canyon View Eyecare PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CANYON VIEW EYECARE PLLC

Practice address

74 E 1St S
Rexburg, ID 83440-1936

Phone

(208) 356-6911

NPI assigned

Sep 17, 2021

Organization subpart

Yes

Parent organization

CANYON VIEW EYECAREAs reported in NPPES

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

Authorized official

Name

Mitch Merrill, ODNPI 1518631282

Title

Owner

Phone

(208) 356-6911

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Part of

Canyon View Eyecare PLLC

Practitioners 2

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

• Mitch Clay Merrill, O.D.

  • Optometrist
  • Rexburg, ID
  • NPI 1518631282
  Medicare reassignment NPD Authorized official
• Shawn Taylor Galbraith, OD

  • Optometrist
  • NPI 1215995832
  NPD (past)

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1184394405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401936",
            "telephone_number": "208-356-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401936",
            "telephone_number": "208-356-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON VIEW EYECARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CANYON VIEW EYECARE",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-356-6911",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "canyonvieweyecare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business",
            "address_1": "74 E 1st S",
            "city": "Rexburg",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834401936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Byington
• Byu Id Student HLTH CNTR Pchy
• Byu Idaho Student Health Center
• Bryce Campbell
• Nora Campbell
• Megan Carlson
• Checotah Carroll
• Jakob Carstens, DPT
• Sara Emily Carter, SLP
• Cody Lane Castellaw, DPT

• Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.