Eye Care for Kids

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE CARE FOR KIDS

Doing business as

Eye Care 4 Kids

Practice address

6911 S State St
Midvale, UT 84047-1239

Phone

(801) 255-8525

Fax

(801) 255-8526

NPI assigned

Jan 24, 2007

Last updated

Oct 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph G. Carbone, ABOC, NCLC

Title

Executive Director

Phone

(801) 255-8525

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Eye Care 4 Kids Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

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.

• Jeffery Lovell Mellor, O.D., M.ED.

  • Optometrist
  • South Jordan, UT
  • NPI 1518975226
  Medicare reassignment NPD
• Michael Green Thain, OD

  • Optometrist
  • Salt Lake City, UT
  • NPI 1356415434
  Medicare reassignment NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1336294750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 S STATE ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471239",
            "telephone_number": "801-255-8525",
            "fax_number": "801-255-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 S STATE ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471239",
            "telephone_number": "801-255-8525",
            "fax_number": "801-255-8526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3733 S 250 W Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844051628",
            "country_code": "US",
            "telephone_number": "385-275-2011",
            "fax_number": "801-255-8526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE CARE FOR KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-255-8525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOC, NCLC"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PRA06546",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care 4 Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brynelle Etheridge
• Albert L Evans, DDS PC
• Rylee Evans
• Everest Health Performance LLC
• Evergreen Place LLC
• Eye Prosthetics of Utah, Inc.
• Margaret Nasareta Faauli
• Lillian Nicole Fackrell, DC
• Jennifer Fairbourn, MS, LMFT
• Joshua Stephen Falk, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.