Shelly L Nielsen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5138127-9934 Issued in UT

Practice address

3571 West 10400 South
South Jordan, UT 84095

Phone

(801) 523-5303

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelly L Leftwich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Modern Vision LLC

  • Optometrist
  • South Jordan, UT
  • NPI 1609304880
  NPD (past) Authorized official
• True Vision Care, LLC

  • Optometrist
  • Pleasant Grove, UT
  • NPI 1801078605
  NPD (past) Authorized official
• Standard Optical Co

  • Optometrist
  • Salt Lake City, UT
  • NPI 1962599290
  NPD (past)
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699864801",
    "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 WEST 10400 SOUTH",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-523-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SHELLY",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5138127-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "LEFTWICH",
            "middle_name": "L",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McKenzie Niebergall, BCABA
• Austin Jay Nielsen, DPT
• Casee Nielsen
• Lanesha Nielsen
• Ryan S Nielsen, APC
• Zachary David Nilson, PHARMD, BCPS
• Angel Ninh-Ho, LCSW
• Nivati Inc
• Rachel Marie Noble, LCSW
• Cody Northup

• 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 Jul 21, 2022; 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.