Riverton Family Eye Care Optometry Practice , LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

E66160 Issued in UT

Legal business name

RIVERTON FAMILY EYE CARE OPTOMETRY PRACTICE , LLC

Practice address

2998 W 12600 S
Riverton, UT 84065-7164

Phone

(801) 446-7600

Fax

(801) 446-0912

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jodie J Johnson, ODNPI 1629001474

Title

Doctor/Owner

Phone

(801) 446-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Riverton Family Eye Care LLC Doing business as
• Riverton Family Eye Care, Optometry Other name

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jodie J Johnson, O.D.

  • Occupational Vision Optometrist
  • Riverton, UT
  • NPI 1629001474
  Medicare reassignment Authorized official
• Jayson Tyler Buhler, OD

  • Optometrist
  • Riverton, UT
  • NPI 1497649131
  NPD
• Jerald T Jolley, O.D.

  • Optometrist
  • Salt Lake City, UT
  • NPI 1538197330
  NPD (past)
• Michael Craig Larsen, OD

  • Optometrist
  • Layton, UT
  • NPI 1720152309
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1336349380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2998 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657164",
            "telephone_number": "801-446-7600",
            "fax_number": "801-446-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2998 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657164",
            "telephone_number": "801-446-7600",
            "fax_number": "801-446-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTON FAMILY EYE CARE OPTOMETRY PRACTICE , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "801-446-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "E66160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526949225003",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverton Family Eye Care LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverton Family Eye Care, Optometry",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Riverton Family Eye Care, Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diane Rindlisbacher
• Shellie J Ring, MD
• River Crossing Dental Professional Corporation
• Riverton Chiropractic LLC
• Riverton Family Dental PLLC
• Riverton Family Health Center L L C
• Riverton Family Health Center LLC
• Riverton Gastroenterology Center LLC
• Riverton Heights Dental Care
• Riverton Heights Dental, Corp.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.