Mt Ogden Eye Center LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

MT OGDEN EYE CENTER LLC

Practice address

4360 Washington Blvd
Ogden, UT 84403-1866

Phone

(801) 476-0494

Fax

(801) 476-0067

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Sarah Howell

Title

Credentialing Manager

Phone

(801) 409-9900

Specialties & licenses 3

Addresses

Other names 1

• UTAH EYE CENTERS Doing business as

Medicare fee-for-service enrollment

Enrolled in UT, WY3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mt Ogden Eye Center LLC

  • Ophthalmology Physician
  • Bountiful, UT
  • NPI 1740431428

  2860474962

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mount Ogden Eye Center

  • Ophthalmologic Surgery Clinic/Center
  • Bountiful, UT
  • NPI 1841421914

  O20040602001630

  Same enrollment
• Mt Ogden Eye Center LLC

  • Ophthalmology Physician
  • Bountiful, UT
  • NPI 1740431428

  O20040602001630

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Mount Ogden Eye Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mt Ogden Eye Center LLC

  • Eyewear Supplier
  • Salt Lake City, UT
  • NPI 1649046269
  NPD tax ID

Locations

Interoperability endpoints

• Direct secure messaging: jarmstrong@utaheyecenters.intellechartdirect.net
• Direct secure messaging: mbullard@utaheyecenters.intellechartdirect.net
• Direct secure messaging: calldredge@utaheyecenters.intellechartdirect.net
• Direct secure messaging: mballif@utaheyecenters.intellechartdirect.net

Practitioners 32

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

• Claron Douglas Alldredge, MD

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1841200284
  Medicare reassignment Care Compare group NPD
• Bradley Anderson, M.D.

  • Ophthalmology Physician
  • Salt Lake City, UT
  • NPI 1952664260
  Medicare reassignment Care Compare group NPD
• Michael Lonnie Bullard, M.D.

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1326351727
  Medicare reassignment Care Compare group NPD
• Devin B Farr, O.D.

  • Optometrist
  • Ogden, UT
  • NPI 1750643896
  Medicare reassignment Care Compare group NPD
• David R Griffin, M.D.

  • Ophthalmology Physician
  • Pleasant Grove, UT
  • NPI 1023471901
  Medicare reassignment Care Compare group NPD
• Isha Gupta, MD

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1972980332
  Medicare reassignment Care Compare group NPD
• Brock C Hansen, M.D.

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1992123376
  Medicare reassignment Care Compare group NPD
• Daxton Aaron Hawks, OD, MBA

  • Optometrist
  • Riverton, UT
  • NPI 1821663675
  Medicare reassignment Care Compare group NPD
• Lisa L Leishman, M.D.

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1932467198

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Jamie M Monroe, MD

  • Ophthalmology Physician
  • Orem, UT
  • NPI 1619075678

  WY

  Medicare reassignment Care Compare group NPD
• Jed T Poll, MD

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1376656124

  Optometrist

  Medicare reassignment Care Compare group NPD
• Kiana Rigby, OD

  • Optometrist
  • Ogden, UT
  • NPI 1750075081
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1700927043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-476-0494",
            "fax_number": "801-476-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-476-0494",
            "fax_number": "801-476-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT OGDEN EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "801-409-9900"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTAH EYE CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mountainstar Ogden Pediatrics LLC
• Joshua Mower
• Moyes Iverson Dental LLC
• Brett K. Moyes, D.D.S.
• Mt Ogden Anesthesia Group LLC
• Mt Ogden Utah Surgical Center LLC
• Mt. Ogden Dental Clinic, Inc.
• Mt. Ogden Surgical Center LLC
• Kody Call Mund, DMD
• Britney Leigh Munday, NP

• Ophthalmology Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.