Jed C Winder OD, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5354338-9934 Issued in UT

Legal business name

JED C WINDER OD, PC

Practice address

300 S Main St
Tooele, UT 84074-2746

Phone

(435) 882-3233

Fax

(435) 882-1626

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jed C Winder, OD

Title

Owner

Phone

(435) 882-3233

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tooele Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 3

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

• Edwin C Winder III, OD

  • Optometrist
  • Tooele, UT
  • NPI 1457369621
  Medicare reassignment NPD
• Kim A. Halladay, D.P.M.

  • Podiatrist
  • Tooele, UT
  • NPI 1902809528
  NPD (past)
• Kris Alfred Hill, OD

  • Optometrist
  • Midvale, UT
  • NPI 1043228554
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1245317445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742746",
            "telephone_number": "435-882-3233",
            "fax_number": "435-882-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742746",
            "telephone_number": "435-882-3233",
            "fax_number": "435-882-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JED C WINDER OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "WINDER",
        "authorized_official_first_name": "JED",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-882-3233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5354338-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528869987001",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529296615001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tooele Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark R. Jackson, MD
• Lu Ann Jacobs-Peterson, APRN FNP
• Carin Renee James
• Chad Jarvis, DA-C
• Jay M. Spector,M.D.,LLC
• Candice Jemison
• Jeramy Rawn Jenkins, AU.D., CCC-A
• Suzanne Renee Jenkins, RRT
• Jesse David Jensen, D.O.
• Jim J. Gould, MD PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.