Individual provider Active NPI

Phillip Lynn Purcell, O.D.

  • Optometrist
  • Tremonton, UT
National Provider Identifier
1356653513
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7714588-9934 Issued in UT
Practice address
495 W 600 N
Tremonton, UT 84337-2411
Phone
(435) 257-7436
NPI assigned
Jul 5, 2010
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7714588-9934 UT Primary

Addresses

Primary practice location

495 W 600 N
Tremonton, UT 84337-2411

Mailing address

PO Box 155
Tremonton, UT 84337-0155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001517 UT Practitioner - Optometry 6002932985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn R. Purcell, O.D., IncGroup PAC ID 9335132463, 2 clinicians

Practice addresses (Care Compare)

495 W 600
Tremonton, UT 84337-1942
Phone (435) 257-7436

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7714588-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bear River Eye Center, Inc Optometrist CurrentSince Jan 1, 2010 Accepting new patients
Mt Ogden Eye Center LLC Optometrist PastSince Aug 1, 2010 Accepting new patients

Locations

495 W 600 N
Tremonton, UT 84337
Phone (435) 257-7436

Interoperability endpoints

  • FHIR API: https://bearrivereye.ef.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: phpurcell@bearrivereye.emadirect.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1356653513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843370155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 W 600 N",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843372411",
            "telephone_number": "435-257-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "PHILLIP",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-05",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "7714588-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tremonton, UT

Sources for this page

Verify at the official NPI Registry.