NPIMap

Organization Active NPI

Wasatch Vision Clinic LLC

  • Optometrist
  • Salt Lake City, UT
National Provider Identifier
1255517637
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WASATCH VISION CLINIC LLC
Practice address
849 E 400 S
Salt Lake City, UT 84102-2928
Phone
(801) 328-2020
Fax
(801) 363-2201
NPI assigned
Jan 15, 2008
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Mr. Craig Cutler, ODNPI 1720056161
Title
Owner
Phone
(801) 328-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X UT Primary

Addresses

Primary practice location

849 E 400 S
Salt Lake City, UT 84102-2928

Mailing address

849 E 400 S
Salt Lake City, UT 84102-2928
Phone (801) 328-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050912000241 UT Part B Supplier - Clinic/Group Practice 8224061239 Receives reassigned benefits from 2 practitioners
Practice locations: Farmington, UT; Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

57 N Main St
Farmington, UT 84025
Phone (801) 447-4390

849 E 400 S
Salt Lake Cty, UT 84102
Phone (801) 328-2020

Practitioners & affiliated clinicians

Practitioners 5

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": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1255517637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 E 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022928",
            "telephone_number": "801-328-2020",
            "fax_number": "801-363-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 E 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022928",
            "telephone_number": "801-328-2020",
            "fax_number": "801-363-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH VISION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-328-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": null,
            "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 Jan 15, 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.