Todd W Mumford, O.D.
Individual provider Active NPI Optometrist · Farr West, UT
NPI 1255412771 · NPPES record last updated Dec 21, 2023
Key facts
- NPI
- 1255412771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8141255-9934 (UT)
- Practice address
- 1741 N 2000 W
Farr West, UT 84404-9810 - Phone
- (017) 315-5558
- Fax
- (801) 731-3143
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aeg Utah Professional Inc
Whipple Eyecare PC
Practice addresses (Care Compare)
1741 N 2000
Suite 7
Farr West, UT 84404-9811
Phone (801) 731-5558
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110125000853 | UT | Practitioner - Optometry | 9234318072 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5641 | OH | MD | Optometrist |
Practice roles (4 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whipple Eyecare PC | Optometrist | Current |
Accepting new patients |
| Ion Vision PLLC | Optometrist | Current |
Accepting new patients |
| Vision Source of South Ogden | Optometrist | Current |
Accepting new patients |
| Aeg Utah Professional Inc | Optometrist | Current |
Accepting new patients |
Locations
1741 N 2000 W
Farr West, UT 84404
Phone (801) 731-3200
1741 N 2000 W
Ste 7
Ogden, UT 84404
Phone (801) 731-5558
3651 Wall Ave
Ste 1226
Ogden, UT 84405
Phone (801) 392-4358
50 S Main St
Ste 115
Salt Lake City, UT 84101
Phone (801) 359-2260
6191 S State St
Ste 301
Salt Lake City, UT 84107
Phone (801) 268-0408
5331 Adams Avenue Pkwy
Ste B
Washington Terrace, UT 84405
Phone (801) 479-7850
Networks
- UT PPO
- UT PPO D-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5641 | OH | |
| Optometrist | 152W00000X | 8141255-9934 | UT | Yes |
Addresses
Primary practice location
1741 N 2000 W
Farr West, UT 84404-9810
Mailing address
1741 N 2000 W
Farr West, UT 84404-9810
Phone (801) 731-5558
Other practice location 1
5331 Adams Ave Pkwy Ste B
Ogden, UT 84405-4755
Phone (801) 479-7850
Other providers in Farr West, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.