Modern Vision LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MODERN VISION LLC

Practice address

3571 W South Jordan Pkwy
South Jordan, UT 84095-7173

Phone

(801) 523-5303

Fax

(801) 523-5301

NPI assigned

Jun 1, 2017

Last updated

Jun 1, 2017By 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. Shelly L Nielsen, ODNPI 1699864801

Title

Manager, Owner, Optometrist

Phone

(801) 919-5154

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Shelly L Nielsen, OD

  • Optometrist
  • South Jordan, UT
  • NPI 1699864801
  NPD (past) Authorized official
• Jessica Lin Ridder, OD

  • Optometrist
  • Saratoga Springs, UT
  • NPI 1144759150
  NPD (past)
• Kera Ann Jones, OD

  • Optometrist
  • Lakeland, FL
  • NPI 1154843423
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496275200000",
    "number": "1609304880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 N 1000 W",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840033897",
            "telephone_number": "801-919-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 W SOUTH JORDAN PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957173",
            "telephone_number": "801-523-5303",
            "fax_number": "801-523-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER, OWNER, OPTOMETRIST",
        "authorized_official_telephone_number": "801-919-5154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylor Miller, LMT
• Kristie S Miller, RN
• Rebecca Ann Miller
• Kristin Minson, PHARMD
• Mobile Docs Utah, LLC
• Omama Mohammed Akbar
• Jennifer Monsen, SCMT, MT-BC
• Lanora Montag, PHARM D
• Isabella Montejo Velasco
• Montera Health Utah LLC

• Optometrist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; 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.