Boomerang Lenses, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

BOOMERANG LENSES, LLC

Practice address

261 W Data Dr
Draper, UT 84020-2372

Phone

(801) 316-7408

NPI assigned

Sep 16, 2020

Last updated

Sep 16, 2020By 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

Kenton Nielson

Title

GM

Phone

(801) 316-7408

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1629684592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 W DATA DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840202372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 W DATA DR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840202372",
            "telephone_number": "801-316-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOMERANG LENSES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "NIELSON",
        "authorized_official_first_name": "KENTON",
        "authorized_official_title_or_position": "GM",
        "authorized_official_telephone_number": "801-316-7408"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Douglas Bohner, MD
• McKenzie Bolen
• Cody Joe Bollschweiler, RBT
• Alyxandra Bolton
• Cynthia Mae Bolton
• McKenna Boothe, LAT, ATC
• David D Borba, CSW
• Tillie Borrelli, DNP
• Bailey Boss
• Farid Boualam, PT, DPT, CSCS

• Eyewear Supplier in Draper, UT
• Providers in Draper, UT by specialty
• Eyewear Supplier in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.