Kyle D Wilson OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KYLE D WILSON OD PC

Practice address

489 W 2275 N Ste B
Layton, UT 84041-7471

Phone

(801) 776-2020

NPI assigned

Aug 27, 2019

Organization subpart

No

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

Authorized official

Name

Kyle Wilson, ODNPI 1508207309

Title

Owner, President

Phone

(801) 473-9002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

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

• Kyle Douglas Wilson, OD

  • Optometrist
  • Farmington, CT
  • NPI 1508207309

  UT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1194373886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 W 2275 N STE B",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 W 2275 N STE B",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840417471",
            "telephone_number": "801-776-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE D WILSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "801-473-9002",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Raymond Kress, MD
• Paige Krier-Martin
• Michael P Kunzler, D.C.
• Samantha Kuss Ribeiro
• Tallulah Kvenvold
• Lia Cutler Kyle
• Renalie Labarda
• Laboratory Corporation of America
• Alexis Lahey
• Kaitlyn Lake

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.