NPIMap

Organization Active NPI

Progressive Eye Care, LLC

  • Optometrist
  • Murray, UT
National Provider Identifier
1659917706
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PROGRESSIVE EYE CARE, LLC
Practice address
192 E 4500 S
Murray, UT 84107-2628
Phone
(801) 261-2020
Fax
(801) 261-2052
NPI assigned
Nov 25, 2019
Organization subpart
Yes
Parent organization
PROGRESSIVE EYE CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Jeffrey L Broadhead, ODNPI 1306829569
Title
Managing Member
Phone
(801) 676-2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X

Addresses

Primary practice location

192 E 4500 S
Murray, UT 84107-2628

Mailing address

192 E 4500 S
Murray, UT 84107-2628
Phone (801) 261-2020

Other names 1

  • Classic Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Progressive Eye Care LLC2 organizations share this tax ID, including this one
Part of
Progressive Eye Care LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1659917706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 E 4500 S",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841072628",
            "telephone_number": "801-261-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 E 4500 S",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841072628",
            "telephone_number": "801-261-2020",
            "fax_number": "801-261-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE EYE CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROGRESSIVE EYE CARE, LLC",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "BROADHEAD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-676-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Classic Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.