Provo Vision & Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PROVO VISION & EYE CARE

Practice address

1313 S University Ave
Provo, UT 84601-5943

Phone

(971) 217-9763

NPI assigned

Nov 2, 2019

Last updated

Nov 2, 2019By 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. Baltazar Vega, OD

Title

Owner/Optometrist

Phone

(971) 217-9763

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572652800000",
    "number": "1568006500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W TWILIGHT CT",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840595580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 S UNIVERSITY AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846015943",
            "telephone_number": "971-217-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO VISION & EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-02",
        "last_updated": "2019-11-02",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "BALTAZAR",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "971-217-9763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.