Jessica Graham

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

5267304-8904 Issued in UT

Practice address

4019 W 12600 South
Suite #110
Riverton, UT 84096

Phone

(801) 302-9482

Fax

(801) 302-5532

NPI assigned

Oct 2, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Washington PLLCGroup PAC ID 4486186657, 50 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Washington, PLLC

  • Optometrist
  • Bountiful, UT
  • NPI 1174404024
  Medicare reassignment Care Compare group NPD
• Total Vision Care, LLC

  dba Valley View Vision

  • Optometrist
  • Riverton, UT
  • NPI 1649460668
  Medicare reassignment NPD
• Esplin Eye Center LLC

  • Optometrist
  • Spanish Fork, UT
  • NPI 1649245333
  Medicare reassignment
• Myeyedr Optometry of Washington, PLLC

  • Optometrist
  • Ogden, UT
  • NPI 1942151998
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801989868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 W 12600 S",
            "address_2": "#110",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "84096",
            "telephone_number": "801-302-9482",
            "fax_number": "801-302-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 W 12600 SOUTH",
            "address_2": "SUITE #110",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "84096",
            "telephone_number": "801-302-9482",
            "fax_number": "801-302-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5267304-9934",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "UT",
            "license": "5267304-8904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "52673049901001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "84414",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP & PENSION ADM.",
            "identifier": "H870369 0819",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL BENEFIT AD",
            "identifier": "868724",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce Dwayne Glad, CSW, BCBA
• Jennifer Lynne Glazier, PA-C
• Joseph Gleed
• Katelyn Ashley Glenn
• Maria Christina Gordon, PHARMD
• Grand Valley Psychiatry
• Granger Medical Clinic Inc (Granger Medical Riverton)
• Granger Medical Clinic, PC (Granger Medical Clinic - Parkway)
• Granger Medical Specialists LLC
• Mikael Lee Kristina Greeff

• Corneal and Contact Management Optometrist in Riverton, UT
• Providers in Riverton, UT by specialty
• Corneal and Contact Management Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.