Individual provider Active NPI

Jarrod Davies, O.D.

  • Optometrist
  • South Jordan, UT
National Provider Identifier
1861621864
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7383319-9934 Issued in UT
Practice address
3672 W South Jordan Pkwy
Ste 103
South Jordan, UT 84009-7171
Phone
(801) 810-1060
NPI assigned
Jul 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Vision Optometrist 152WS0006X 7383319-9934 UT
Pediatric Optometrist 152WP0200X 7383319-9934 UT
Vision Therapy Optometrist 152WV0400X 7383319-9934 UT
Optometrist 152W00000X 7383319-9934 UT Primary

Addresses

Primary practice location

3672 W South Jordan Pkwy
Ste 103
South Jordan, UT 84009-7171

Mailing address

3672 W South Jordan Pkwy
Ste 103
South Jordan, UT 84009-7171
Phone (801) 810-1060

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091224000032 UT Practitioner - Optometry 5597805408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Vision Development Center, LLCGroup PAC ID 8527241363, 2 clinicians

Practice addresses (Care Compare)

12523 S Pasture Rd
Suite 200
Riverton, UT 84096-4840
Phone (801) 810-1060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7383319-9934UTMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Vision Development Center, LLC Optometrist CurrentSince Feb 1, 2011 Accepting new patients
Child & Family Eyecare Center, LLC Optometrist PastSince Oct 13, 2019 Accepting new patients
Achieve Vision Therapy Center Vision Therapy PastSince Sep 23, 2021 Accepting new patients

Locations

12523 S Pasture Rd
Riverton, UT 84096

12523 S Pasture Rd
Ste 200
Riverton, UT 84096
Phone (801) 810-1060

3590 W 9000 S
Ste 315
West Jordan, UT 84088
Phone (801) 561-1100

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1861621864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3672 W SOUTH JORDAN PKWY",
            "address_2": "STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097171",
            "telephone_number": "801-810-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3672 W SOUTH JORDAN PKWY",
            "address_2": "STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097171",
            "telephone_number": "801-810-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "JARROD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "UT",
            "license": "7383319-9934",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "UT",
            "license": "7383319-9934",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "UT",
            "license": "7383319-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "7383319-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.