NPIMap

Organization Active NPI

Spencer D Johnson OD PC

Doing business as South Hills Family Eye Care

  • Optometrist
  • Draper, UT
National Provider Identifier
1336315613
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5937796-9934 Issued in UT
Legal business name
SPENCER D JOHNSON OD PC
Doing business as
South Hills Family Eye Care
Practice address
12357 S 450 E
Ste 2
Draper, UT 84020-8127
Phone
(801) 572-9804
Fax
(801) 572-9805
NPI assigned
May 6, 2008
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Dr. Spencer D Johnson, O.D.NPI 1487747408
Title
Owner/Optometrist
Phone
(801) 572-9804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5937796-9934 UT Primary

Addresses

Primary practice location

12357 S 450 E
Ste 2
Draper, UT 84020-8127

Mailing address

12357 S 450 E
Ste 2
Draper, UT 84020-8127
Phone (801) 572-9804

Other names 1

  • South Hills Family Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

12357 S 450 E
Ste 2
Draper, UT 84020
Phone (801) 572-9804

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1336315613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12357 S 450 E",
            "address_2": "STE 2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208127",
            "telephone_number": "801-572-9804",
            "fax_number": "801-572-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12357 S 450 E",
            "address_2": "STE 2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208127",
            "telephone_number": "801-572-9804",
            "fax_number": "801-572-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER D JOHNSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "801-572-9804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5937796-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Hills Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.