Active NPI
Paley Anderson
- Optometrist
- Salt Lake City, UT
National Provider Identifier
1790630804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 142939429934
- Practice address
- 500 Foothill Dr
Salt Lake City, UT 84148-0001 - Phone
- (801) 582-1565
- NPI assigned
- Mar 3, 2026
- Reactivated
- Jul 28, 2026
- Last updated
- Sep 9, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 142939429934 | UT | Primary |
Addresses
Primary practice location
500 Foothill Dr
Salt Lake City, UT 84148-0001
Mailing address
9 Honeysuckle LN
Mountain BRK, AL 35213-3011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1790630804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HONEYSUCKLE LN",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352133011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 FOOTHILL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841480001",
"telephone_number": "801-582-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "PALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-03",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"deactivation_date": "2026-06-09",
"reactivation_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "142939429934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.