NPIMap

Organization Active NPI

U of U Rocky Mountain Ophthalmology

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1831134519
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
U OF U ROCKY MOUNTAIN OPHTHALMOLOGY
Practice address
4400 S 700 E
Salt Lake City, UT 84107-3000
Phone
(801) 264-4464
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Randall J Olson, MDNPI 1518057132
Title
Department Chair
Phone
(801) 581-3195

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X
Contact Lens Technician/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 156FC0800X
Contact Lens FitterGroup: 193200000X MULTI-SPECIALTY GROUP 156FC0801X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4400 S 700 E
Salt Lake City, UT 84107-3000

Mailing address

4400 S 700 E
Salt Lake City, UT 84107-3000
Phone (801) 264-4464

Other identifiers 2

IdentifierTypeStateIssuer
807025800OtherIDIDAHO MEDICAID
114230500OtherWYWYOMING MEDICAID

National Provider Directory

National Provider Directory

Locations

4400 S 7th E
Salt Lake Cty, UT 84107
Phone (801) 264-4450

Practitioners & affiliated clinicians

Practitioners 1

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1831134519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073000",
            "telephone_number": "801-264-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073000",
            "telephone_number": "801-264-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U OF U ROCKY MOUNTAIN OPHTHALMOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "801-581-3195",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO MEDICAID",
            "identifier": "807025800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING MEDICAID",
            "identifier": "114230500",
            "state": "WY"
        }
    ],
    "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 6, 2011; 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.