Eye Care Group of Utah LC

Primary specialty

SpecialistTaxonomy code 174400000X

License

60698760160 Issued in UT

Legal business name

EYE CARE GROUP OF UTAH LC

Doing business as

Eye Foundation of Utah

Practice address

201 E 5900 S
Suite 201
Murray, UT 84107-7379

Phone

(801) 268-6408

Fax

(801) 262-9216

NPI assigned

May 18, 2006

Last updated

Dec 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert P WooldridgeNPI 1013962828

Title

Director

Phone

(801) 268-6408

Specialties & licenses 1

Addresses

Other names 1

• Eye Foundation of Utah Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Anderson, M.D.

  • Ophthalmology Physician
  • Salt Lake City, UT
  • NPI 1952664260
  Medicare reassignment NPD
• Jed T Poll, MD

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1376656124
  Medicare reassignment NPD
• Michael B Wilcox, MD

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1053391771
  Medicare reassignment NPD
• Peter Garrett Coombs, MD

  • Retina Specialist (Ophthalmology) Physician
  • Hawthorne, NY
  • NPI 1306137104

  Single Specialty, UT

  Medicare reassignment NPD
• Robert P Wooldridge, O.D. PC

  • Optometrist
  • Murray, UT
  • NPI 1013962828
  NPD Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1407809551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 5900 S",
            "address_2": "SUITE 201",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077379",
            "telephone_number": "801-268-6408",
            "fax_number": "801-262-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 5900 S",
            "address_2": "SUITE 201",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077379",
            "telephone_number": "801-268-6408",
            "fax_number": "801-262-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE GROUP OF UTAH LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-268-6408"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "60698760160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Foundation of Utah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Foundation of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Everhart, MS,RD,CSSD
• Excell Medical Center, Inc.
• Exemplar Healthcare, Inc. (Symbii Home Health South)
• Exemplar Healthcare, Inc. (Symbii Hospice South)
• Extend Your Ohana LLC
• Eyemax Eyecare, PLLC.
• Edward Joseph Eyring II, M.D.
• Simon Faavaoga
• Sergio Fabert
• Rachel Fagergren, PHARMD

• Specialist in Murray, UT
• Providers in Murray, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.