Eye Center of Ephraim, LLC
Organization Active NPI Optometrist · Ephraim, UT
NPI 1457548216 · NPPES record last updated Jan 5, 2009
Key facts
- NPI
- 1457548216
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 284643-9934 (UT)
- Legal business name
- EYE CENTER OF EPHRAIM, LLC
- Practice address
- 43 E 450 N
Ephraim, UT 84627-4027 - Phone
- (435) 283-5555
- Fax
- (435) 283-8642
- NPI assigned
- Sep 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Darin Ray Cummings, O.D.
- Title
- Owner
- Phone
- (435) 283-5555
Practitioners 2
-
Darin R. Cummings, O.D.
-
Jacob Michael Robison, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071121000244 | UT | Part B Supplier - Clinic/Group Practice | 8820186059 |
Receives reassigned benefits from 2 practitioners Practice locations: Ephraim, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 284643-9934 | UT | Yes |
Addresses
Primary practice location
43 E 450 N
Ephraim, UT 84627-4027
Mailing address
43 E 450 N
Ephraim, UT 84627-4027
Phone (435) 283-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004532 | Other | UNITED HEALTHCARE | |
| 328071 | Other | UT | ALTIUS |
| 20005965601001 | Other | UT | REGENCE BCBS - GROUP |
| DN6778 | Other | RAILROAD MEDICARE PTAN | |
| 107008974104 | Other | SELECT HEALTH |
Other providers in Ephraim, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.