Individual provider Active NPI

Jeffery Donald Graf, OD

  • Optometrist
  • Saint George, UT
National Provider Identifier
1184628091
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
114436-9934 Issued in UT
Practice address
754 S Main St
Ste 6
Saint George, UT 84770-5504
Phone
(435) 634-0420
Fax
(435) 634-5409
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 114436-9934 UT Primary
Corneal and Contact Management Optometrist 152WC0802X 114436-9934 UT
Low Vision Rehabilitation Optometrist 152WL0500X 114436-9934 UT
Pediatric Optometrist 152WP0200X 114436-9934 UT

Addresses

Primary practice location

754 S Main St
Ste 6
Saint George, UT 84770-5504

Mailing address

754 S Main St
Ste 6
Saint George, UT 84770-5504
Phone (435) 634-0420

Other identifiers 1

IdentifierTypeStateIssuer
410021393OtherRAILROAD MEDICARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
114436-9934UTMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Cliffs Eye Center, PLLC Optometrist CurrentSince May 7, 2023 Accepting new patients

Locations

754 S Main St
Ste 6
St George, UT 84770
Phone (435) 634-0420

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1184628091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST",
            "address_2": "STE 6",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705504",
            "telephone_number": "435-634-0420",
            "fax_number": "435-634-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 S MAIN ST",
            "address_2": "STE 6",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705504",
            "telephone_number": "435-634-0420",
            "fax_number": "435-634-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAF",
        "first_name": "JEFFERY",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "114436-9934",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "UT",
            "license": "114436-9934",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "UT",
            "license": "114436-9934",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "UT",
            "license": "114436-9934",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410021393",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.