Individual provider Active NPI

Jason Edward Holmes, O.D.

  • Optometrist
  • West Jordan, UT
National Provider Identifier
1194776005
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
114312-9934 Issued in UT
Practice address
1553 W 9000 S
West Jordan, UT 84088-9219
Phone
(801) 561-7300
Fax
(801) 561-7300
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 114312-9934 UT Primary

Addresses

Primary practice location

1553 W 9000 S
West Jordan, UT 84088-9219

Mailing address

1553 W 9000 S
West Jordan, UT 84088-9219
Phone (801) 561-7300

Other identifiers 1

IdentifierTypeStateIssuer
410985054103MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130001027 UT Practitioner - Optometry 9830154905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis Vision Center Associates PLLCGroup PAC ID 0446388805, 4 clinicians

Practice addresses (Care Compare)

11649 S 4000
Suite 200
South Jordan, UT 84009-6048
Phone (801) 253-3080

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Vision Center Associates PLLC CurrentSince Nov 5, 2020 Accepting new patients
Davis Vision Center Past Accepting new patients

Locations

11649 S 4000 W
Ste 200
South Jordan, UT 84009
Phone (801) 253-3080

Networks

  • UT PPO
  • UT PPO D-SNP

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/imedicware_davisvisioncenter

Organizations & group practices 2

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194776005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889219",
            "telephone_number": "801-561-7300",
            "fax_number": "801-561-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889219",
            "telephone_number": "801-561-7300",
            "fax_number": "801-561-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "114312-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410985054103",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.