Organization Active NPI

Cottonwood Ophthalmology Associates Inc

  • Ophthalmology Physician
  • Murray, UT
National Provider Identifier
1700062049
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
290691-1205 Issued in UT
Legal business name
COTTONWOOD OPHTHALMOLOGY ASSOCIATES INC
Practice address
164 E 5900 S
#A101
Murray, UT 84107-7256
Phone
(801) 262-3344
Fax
(801) 262-4967
NPI assigned
Jan 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
John Bryant Alder, M.D.NPI 1508829144
Title
President
Phone
(801) 262-3344

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 290691-1205 UT Primary

Addresses

Primary practice location

164 E 5900 S
#A101
Murray, UT 84107-7256

Mailing address

164 E 5900 S
#A101
Murray, UT 84107-7256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080220000099 UT Part B Supplier - Clinic/Group Practice 4284718925 Receives reassigned benefits from 1 practitioner
Practice locations: Murray, UT

National Provider Directory

National Provider Directory

Locations

164 E 5900 S
Ste A101
Murray, UT 84107
Phone (801) 261-5790

Practitioners & affiliated clinicians

Practitioners 2

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": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1700062049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 E 5900 S",
            "address_2": "#A101",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 E 5900 S",
            "address_2": "#A101",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077256",
            "telephone_number": "801-262-3344",
            "fax_number": "801-262-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD OPHTHALMOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "ALDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-262-3344",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "290691-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.