Individual provider Active NPI

Aubri Ann Stclair, ABOC

  • Optician
  • Eagle Mountain, UT
National Provider Identifier
1821643982
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
161061 Issued in KY
Practice address
1036 E Waddell St
Eagle Mountain, UT 84005-4239
Phone
(801) 901-0911
Fax
(801) 206-2950
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 161061 KY Primary

Addresses

Primary practice location

1036 E Waddell St
Eagle Mountain, UT 84005-4239

Mailing address

1036 E Waddell St
Eagle Mountain, UT 84005-4239
Phone (801) 901-0911

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

State licenses

LicenseStateTypeSpecialty
161061KYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1821643982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 E WADDELL ST",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840054239",
            "telephone_number": "801-901-0911",
            "fax_number": "801-206-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 E WADDELL ST",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840054239",
            "telephone_number": "801-901-0911",
            "fax_number": "801-206-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STCLAIR",
        "first_name": "AUBRI",
        "middle_name": "ANN",
        "credential": "ABOC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "161061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.