Organization Active NPI

Cache Valley Eye Associates, PLLC

  • Ophthalmology Physician
  • Logan, UT
National Provider Identifier
1558513895
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CACHE VALLEY EYE ASSOCIATES, PLLC
Practice address
1300 N 500 E
Suite 350
Logan, UT 84341-2408
Phone
(435) 752-7445
Fax
(435) 753-3059
NPI assigned
Oct 17, 2008
Last updated
Nov 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
David G WatermanNPI 1689603284
Title
Vice President
Phone
(435) 752-7445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1300 N 500 E
Suite 350
Logan, UT 84341-2408

Mailing address

1300 N 500 E Ste 350
Logan, UT 84341-2469
Phone (435) 752-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000720 UT Part B Supplier - Clinic/Group Practice 6507927886 Receives reassigned benefits from 5 practitioners
Practice locations: Logan, UT

National Provider Directory

National Provider Directory

Locations

1300 N 500 E
Ste 350
Logan, UT 84341
Phone (435) 752-7445

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1558513895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 500 E STE 350",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412469",
            "telephone_number": "435-752-7445",
            "fax_number": "435-753-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 500 E",
            "address_2": "SUITE 350",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412408",
            "telephone_number": "435-752-7445",
            "fax_number": "435-753-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACHE VALLEY EYE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-17",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "435-752-7445"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.