Retina and Vitreous Surgeons of Utah, LLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

RETINA AND VITREOUS SURGEONS OF UTAH, LLC

Practice address

1055 N 300 W Ste 500
Provo, UT 84604-3312

Phone

(801) 357-7704

Fax

(801) 357-7424

NPI assigned

Sep 26, 2008

Last updated

Aug 16, 2023By 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

Dr. Richard P Corey, M.D.NPI 1568529105

Title

President

Phone

(801) 357-7704

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: rwelch@rvsu.intellechartdirect.net

Practitioners 8

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.

• Richard Paul Corey, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Provo, UT
  • NPI 1568529105
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Franklin Isom, MD

  • Retina Specialist (Ophthalmology) Physician
  • Provo, UT
  • NPI 1679756019
  Medicare reassignment Care Compare group NPD
• Jack Dunyon Stringham II, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Provo, UT
  • NPI 1235496357
  Medicare reassignment Care Compare group NPD
• Robert Joel Welch, MD

  • Retina Specialist (Ophthalmology) Physician
  • Provo, UT
  • NPI 1376981894
  Medicare reassignment Care Compare group
• Jeffrey E Hansen, MD

  • Ophthalmology Physician
  • Price, UT
  • NPI 1386751634
  NPD (past)
• Jason Kowallis, OD

  • Optometrist
  • Roosevelt, UT
  • NPI 1942561311
  NPD (past)
• Judy Olson Saccomanno, OD

  • Optometrist
  • Price, UT
  • NPI 1508993775
  NPD (past)
• Richard I Yardley, O.D.

  • Optometrist
  • Richfield, UT
  • NPI 1013018084
  NPD (past)

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1518117407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 500",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043312",
            "telephone_number": "801-357-7704",
            "fax_number": "801-357-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 500",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043312",
            "telephone_number": "801-357-7704",
            "fax_number": "801-357-7424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11820 S State St Ste 320",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840207170",
            "country_code": "US",
            "telephone_number": "385-237-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5171 S Cottonwood St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075717",
            "country_code": "US",
            "telephone_number": "801-892-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 S 1040 W",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "UT",
            "postal_code": "846514643",
            "country_code": "US",
            "telephone_number": "801-406-1075",
            "fax_number": "801-357-7424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RETINA AND VITREOUS SURGEONS OF UTAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-357-7704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Retina Specialist (Ophthalmology) Physician in Provo, UT
• Providers in Provo, UT by specialty
• Retina Specialist (Ophthalmology) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.