Salmon River Vision Clinic, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100011 Issued in ID

Legal business name

SALMON RIVER VISION CLINIC, PLLC

Practice address

603 Shoup St
Salmon, ID 83467-4259

Phone

(208) 756-2020

Fax

(208) 756-3741

NPI assigned

Feb 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dustin James Jones, O.D.NPI 1174612394

Title

Owner

Phone

(208) 756-2020

Specialties & licenses 1

Addresses

Other names 1

• Scott Burns Taylor Former legal business name

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Dustin J Jones, OD

  • Corneal and Contact Management Optometrist
  • Salmon, ID
  • NPI 1174612394
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1396018461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SHOUP ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674259",
            "telephone_number": "208-756-2020",
            "fax_number": "208-756-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 SHOUP ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674259",
            "telephone_number": "208-756-2020",
            "fax_number": "208-756-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALMON RIVER VISION CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-756-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott Burns Taylor",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Scott Burns Taylor",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Salmon River Chiropractic Inc.
• Salmon River Clinic
• Salmon River Joint School District #243
• Salmon Speech and Swallowing Service
• Salmon Valley Home Health LLC
• Saveway Market Inc
• Sawtooth Healthcare, Inc.
• Sawtooth Healthcare, Inc.

• Optometrist in Salmon, ID
• Providers in Salmon, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.