John Ellison, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6617396-9934 Issued in UT

Practice address

5421 S 1900 W
Roy, UT 84067-2908

Phone

(801) 825-9703

NPI assigned

Mar 4, 2008

Last updated

Nov 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Standard Optical Co

  • Optometrist
  • Orem, UT
  • NPI 1093816548
  Medicare reassignment NPD
• Standard Optical Co

  • Optometrist
  • West Jordan, UT
  • NPI 1861593386
  NPD
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD
• Standard Optical Co

  • Optometrist
  • Holladay, UT
  • NPI 1043311582
  NPD (past)
• Standard Optical Co

  • Optometrist
  • South Jordan, UT
  • NPI 1114377165
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Roy, UT
  • NPI 1396832655
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Tooele, UT
  • NPI 1477654846
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Murray, UT
  • NPI 1508967977
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Taylorsville, UT
  • NPI 1689775041
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Layton, UT
  • NPI 1760583298
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Provo, UT
  • NPI 1891882155
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Salt Lake City, UT
  • NPI 1962599290
  NPD (past)

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1376713586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 S 1900 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840672908",
            "telephone_number": "801-825-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 S 1900 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840672908",
            "telephone_number": "801-825-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "6617396-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mykenzie Dunham
• Lisa Eberly, BCABA, LABA
• Jillee Ehrhart
• Emily Ellis, RN
• Kurtis Don Ellis, M.D.
• Melanie Elm, RPH
• Haleigh Emerson, MD
• Empowered Mind
• Caren D Erekson, DNP, APRN, FNP-C
• Paige Christiana Erickson, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.