NPIMap

Organization Active NPI

Legacy Medical PC

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1235266776
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
155564-1205 Issued in UT
Legal business name
LEGACY MEDICAL PC
Practice address
4400 S 700 E Ste 140
Salt Lake City, UT 84107-3053
Phone
(801) 288-0067
Fax
(801) 288-0067
NPI assigned
Feb 28, 2007
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Dr. Oren Claron Alldredge, MDNPI 1780685412
Title
President
Phone
(801) 288-0067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 155564-1205 UT Primary

Addresses

Primary practice location

4400 S 700 E Ste 140
Salt Lake City, UT 84107-3053

Mailing address

4400 S 700 E Ste 140
Salt Lake City, UT 84107-3053
Phone (801) 288-0067

National Provider Directory

National Provider Directory

Locations

4400 S 7th E
Ste 140
Salt Lake City, UT 84107
Phone (801) 288-0067

4400 S 700 E
#140
Salt Lake Cty, UT 84107
Phone (801) 288-0067

10011 S Centennial Pkwy
Ste 400
Sandy, UT 84070
Phone (801) 568-0200

Practitioners & affiliated clinicians

Practitioners 6

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1235266776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 S 700 E STE 140",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073053",
            "telephone_number": "801-288-0067",
            "fax_number": "801-288-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 S 700 E STE 140",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073053",
            "telephone_number": "801-288-0067",
            "fax_number": "801-288-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "ALLDREDGE",
        "authorized_official_first_name": "OREN",
        "authorized_official_middle_name": "CLARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-288-0067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "155564-1205",
            "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 Oct 24, 2007; 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.