Dr. Courtney Sivertson, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6246453-9934 Issued in UT

Legal business name

DR. COURTNEY SIVERTSON, P.C.

Practice address

7915 Citori Dr
E102
Sandy, UT 84070-0196

Phone

(801) 471-1055

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Courtney Ray Sivertson, O.D.

Title

President

Phone

(801) 471-1055

Specialties & licenses 1

Addresses

Other names 1

• Mountain Home Eye Care Doing business as

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669575833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 CITORI DR",
            "address_2": "E102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840700196",
            "telephone_number": "801-471-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 CITORI DR",
            "address_2": "E102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840700196",
            "telephone_number": "801-471-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. COURTNEY SIVERTSON, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIVERTSON",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-471-1055",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "6246453-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Home Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Sandy, UT
• Providers in Sandy, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.