Organization Active NPI

Mountain View Family Eyecare PLLC

  • Optometrist
  • Heber City, UT
National Provider Identifier
1801198247
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7671967-9934 Issued in UT
Legal business name
MOUNTAIN VIEW FAMILY EYECARE PLLC
Practice address
425 E 1200 S
Ste 200
Heber City, UT 84032-3943
Phone
(435) 657-1555
Fax
(435) 657-1556
NPI assigned
Nov 17, 2010
Last updated
Jan 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Dr. Tory Justine Goode, ODNPI 1154569796
Title
Optometrist/Owner
Phone
(435) 657-1555

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 7671967-9934 UT Primary

Addresses

Primary practice location

425 E 1200 S
Ste 200
Heber City, UT 84032-3943

Mailing address

PO Box 511
Heber City, UT 84032-0511
Phone (435) 657-1555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101230000653 UT Part B Supplier - Clinic/Group Practice 5496943748 Receives reassigned benefits from 1 practitioner
Practice locations: Heber City, UT

National Provider Directory

National Provider Directory

Locations

150 N Main St
Ste 201
Heber City, UT 84032
Phone (435) 657-1555

425 E 1200 S
Heber City, UT 84032
Phone (435) 654-4004

425 E 1200 S
Ste 200
Heber City, UT 84032
Phone (435) 657-1555

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1801198247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840320511",
            "telephone_number": "435-657-1555",
            "fax_number": "435-657-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 1200 S",
            "address_2": "STE 200",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323943",
            "telephone_number": "435-657-1555",
            "fax_number": "435-657-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW FAMILY EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "TORY",
        "authorized_official_middle_name": "JUSTINE",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "435-657-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "7671967-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.