Salem Hills Family Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SALEM HILLS FAMILY EYECARE LLC

Practice address

446 N State Road 198
Salem, UT 84653-4605

Phone

(801) 368-5987

NPI assigned

May 22, 2019

Last updated

May 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas ClarkNPI 1487008603

Title

Ceo

Phone

(801) 368-5987

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

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.

• Douglas Robert Clark, O.D.

  • Optometrist
  • Salem, UT
  • NPI 1487008603
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1831756055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 N STATE ROAD 198",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846534605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 N STATE ROAD 198",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846534605",
            "telephone_number": "801-368-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM HILLS FAMILY EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-368-5987"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrie Rebecca Robinette, ATC
• Jerianne Robinson, BCBA
• Matthew Rumsey
• Katie Grace Ruri, AGPCNP
• Salem City Corporation (Salem Emer Med Assn)
• Salem Hills Pharmacy Inc (Salem Hills Pharmacy)
• Madison Salimbene
• Tessa Nicole Salisbury, PH.D.
• Nathan Sanborn, PA
• Sandstone Autism Services

• Optometrist in Salem, UT
• Providers in Salem, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.