Optometryprnpc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTOMETRYPRNPC

Practice address

914 Fort Union Blvd
Midvale, UT 84047-1714

Phone

(801) 561-4282

Fax

(801) 561-4283

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Tina C. Martin, O.D.

Title

Optometrist, Owner

Phone

(801) 561-4282

Specialties & licenses 1

Addresses

Other names 1

• Family Center Vision Clinic Doing business as

Locations

Practitioners 2

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

• Duane Lee Tanner, O.D.

  • Optometrist
  • Midvale, UT
  • NPI 1730197245
  NPD (past)
• Chad Kay Fellows, OD

  • Optometrist
  • Colchester, VT
  • NPI 1750345369
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720185952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471714",
            "telephone_number": "801-561-4282",
            "fax_number": "801-561-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471714",
            "telephone_number": "801-561-4282",
            "fax_number": "801-561-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRYPRNPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OPTOMETRIST, OWNER",
        "authorized_official_telephone_number": "801-561-4282",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Center Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tania Oliveira, APRN
• Jennifer Ollerton
• Jeffery L. Olson, PHARMD, BCPS
• Zoe Abigail Onion, MD
• Onsite Care at Overstock
• Oral & Maxillofacial Imaging Center, Inc.
• Matthew Ortman, PHARMD
• Jennifer D Osorio
• Katherine Ovrom
• Christian Ownsbey, MAC

• Optometrist in Midvale, UT
• Providers in Midvale, 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.