Jacob Hansen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9432999-9934 Issued in UT

Practice address

1295 N Canyon Creek Pkwy
Spanish Fork, UT 84660-1319

Phone

(801) 504-9645

NPI assigned

Apr 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO
• UT PPO D-SNP

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.

• National Vision Inc

  • Optometrist
  • Spanish Fork, UT
  • NPI 1679240121
  NPD
• America'S Best Contasts & Eyeglasses

  • Optician
  • South Jordan, UT
  • NPI 1801115316
  NPD (past)

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1255894804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 N CANYON CREEK PKWY",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601319",
            "telephone_number": "801-504-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 N CANYON CREEK PKWY",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601319",
            "telephone_number": "801-504-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JACOB",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "9432999-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Breck Hall, DO
• Leah M Hall, LMT
• Vanessa Elizabeth Halvorsen, DO
• Emma Hammer, LMT
• Hanna Hansen
• Lynn Hansen
• Taryn Haralson, MS, CCC-SLP
• Allison Harris
• Meghan Harris
• Andrew L Haskell, OT

• Optometrist in Spanish Fork, UT
• Providers in Spanish Fork, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.