South Valley Eyecare Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

346644-9934 Issued in UT

Legal business name

SOUTH VALLEY EYECARE CENTER, INC.

Practice address

276 Springcreek Pkwy
Providence, UT 84332

Phone

(435) 713-4444

Fax

(435) 787-1238

NPI assigned

Jul 29, 2009

Organization subpart

No

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

Authorized official

Name

David Allen Smith, O.D.NPI 1417067950

Title

President

Phone

(435) 713-4444

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

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

• David Alan Smith, O.D.

  • Optometrist
  • Providence, UT
  • NPI 1417067950
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1528299245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 SPRINGCREEK PKWY",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "84332",
            "telephone_number": "435-713-4444",
            "fax_number": "435-787-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 SPRINGCREEK PKWY",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "84332",
            "telephone_number": "435-713-4444",
            "fax_number": "435-787-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH VALLEY EYECARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-713-4444",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "346644-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "615808",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000053383",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51811974400001",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518119744008",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sierra Chiropractic, PLLC
• Sleepy Smiles LLC
• David Alan Smith, O.D.
• Evan Smith
• Katie Snow
• South Valley Pharmacy
• Spring Creek Dental Associates, LLC
• Spring Creek Surgical Center, LLC
• Springcreek Medical Center PC
• Jonathan Patrick Sprouse

• Optometrist in Providence, UT
• Providers in Providence, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.