Scott Roberts Haderlie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1142339934 Issued in UT

Practice address

747 S Main St
Brigham City, UT 84302-3359

Phone

(435) 723-1800

NPI assigned

May 10, 2006

Last updated

Jul 13, 2026By 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)

Enrolled

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.

• Shoptikal LLC

  dba Shopko Optical 4084

  • Eyewear Supplier
  • West Jordan, UT
  • NPI 1407412885

  Optometrist

  Medicare reassignment NPD
• Shoptikal LLC

  dba Shopko Optical 4088

  • Eyewear Supplier
  • Layton, UT
  • NPI 1134785512

  Optometrist

  NPD
• Shoptikal LLC

  dba Fielmann Vision Care 4313

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386694677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 S MAIN ST",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023359",
            "telephone_number": "435-723-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S MAIN ST",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023359",
            "telephone_number": "435-723-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADERLIE",
        "first_name": "SCOTT",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1142339934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Grisham
• Nathan M Guertler
• Gunnison Valley Hospital (MSM Brigham City)
• Gunnison Valley Hospital (Monument Healthcare Pioneer Trail)
• Gunnison Valley Hospital (Monument Healthcare Brigham City)
• Kalee Hadlock-Bartell
• Julie Ann Haggerty, CPCI
• William Haigh
• Kyle Haines, PT
• Conner Hales

• Optometrist in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.