Organization Active NPI

Nebo Vision Inc.

  • Eyewear Supplier
  • Nephi, UT
National Provider Identifier
1285678565
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
NEBO VISION INC.
Practice address
48 S Main St
Nephi, UT 84648-1708
Phone
(435) 623-2100
Fax
(435) 623-1671
NPI assigned
Jun 16, 2006
Last updated
Jan 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Authorized official

Name
Clinton H Pew
Title
Vice President
Phone
(435) 632-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

48 S Main St
Nephi, UT 84648-1708

Mailing address

48 S Main St
PO Box 196
Nephi, UT 84648-1708
Phone (435) 623-2100

Other identifiers 1

IdentifierTypeStateIssuer
870496971002MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050804001250 UT Part B Supplier - Clinic/Group Practice 9638108160 Receives reassigned benefits from 1 practitioner
Practice locations: Delta, UT; Nephi, UT

National Provider Directory

National Provider Directory

Locations

360 E Main St
#A1
Delta, UT 84624
Phone (435) 864-3243

48 S Main St
Nephi, UT 84648
Phone (435) 623-2100

Practitioners & affiliated clinicians

Practitioners 1

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1285678565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 S MAIN ST",
            "address_2": "PO BOX 196",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846481708",
            "telephone_number": "435-623-2100",
            "fax_number": "435-623-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 S MAIN ST",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846481708",
            "telephone_number": "435-623-2100",
            "fax_number": "435-623-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBO VISION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "PEW",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "435-632-2100"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870496971002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nephi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.