Thomas Edward Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

11777686-9934 Issued in UT

Practice address

3672 W South Jordan Pkwy Ste 103
South Jordan, UT 84009-7172

Phone

(801) 810-1060

NPI assigned

Jun 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Vision Development Center, LLCGroup PAC ID 8527241363, 2 clinicians

Practice addresses (Care Compare)

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.

• Utah Vision Development Center, LLC

  • Optometrist
  • South Jordan, UT
  • NPI 1104123801
  Medicare reassignment Care Compare group NPD
• Kenneth E Hooton, O.D.

  dba Clear View Vision Center

  • Optometrist
  • American Fork, UT
  • NPI 1134390255
  Medicare reassignment NPD

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1669096020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 E 200 N",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622821",
            "telephone_number": "385-439-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3672 W SOUTH JORDAN PKWY STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097172",
            "telephone_number": "801-810-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "UT",
            "license": "11777686-9934",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "UT",
            "license": "11777686-9934",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "UT",
            "license": "11777686-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "11777686-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Dental P.C.
• Brianna Clark
• Cameron Clark
• Elizabeth Clark
• Shay Clark, APC
• Amanda Clavell
• Terri Lee Hopkins Clawson, DHSC, PA-C
• Cindy Clayborn
• Clean Clinic
• Elyzabeth Clegg

• 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 2, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.