Brent L Hadlock, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

110079-9934 Issued in UT

Practice address

1448 S State St
Orem, UT 84097-7704

Phone

(801) 224-0451

Fax

(801) 224-0452

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Standard Optical Co

  • Optometrist
  • Orem, UT
  • NPI 1093816548
  Medicare reassignment NPD
• Visionworks, Inc.

  • Optometrist
  • Salt Lake City, UT
  • NPI 1649203381
  Medicare reassignment NPD
• Brent L. Hadlock, OD, PC

  • Durable Medical Equipment & Medical Supplies
  • Orem, UT
  • NPI 1982722443
  NPD (past) Authorized official
• Standard Optical Co

  • Optometrist
  • Lehi, UT
  • NPI 1023242435
  NPD
• Visionworks, Inc

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD
• Standard Optical Co

  • Optometrist
  • Holladay, UT
  • NPI 1043311582
  NPD (past)
• Standard Optical Co

  • Optometrist
  • South Jordan, UT
  • NPI 1114377165
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Logan, UT
  • NPI 1215038724
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Roy, UT
  • NPI 1396832655
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Tooele, UT
  • NPI 1477654846
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Murray, UT
  • NPI 1508967977
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Taylorsville, UT
  • NPI 1689775041
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578648564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977704",
            "telephone_number": "801-224-0451",
            "fax_number": "801-224-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 S STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977704",
            "telephone_number": "801-224-0451",
            "fax_number": "801-224-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLOCK",
        "first_name": "BRENT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "110079-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0897090001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin C Haacke, AMFT
• Douglas W Hacking, M.D.
• Sydney Haddock
• Kiersten Haderlie, BS, MFT
• Carin B Hadley, SPEECH PATHOLOGIST
• Katherine Marie Hadlock, PA-C
• William Pierce Hadlock
• Morgan Hafen
• Taylor Hafer, PA-C
• Keith Allan Hahn, APRN

• All providers in Orem, UT
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.