NPIMap

Organization Active NPI

Michael M Judkins and Associates, Inc.

  • Optometrist
  • Ogden, UT
National Provider Identifier
1871696179
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
375535-9934 Issued in UT
Legal business name
MICHAEL M JUDKINS AND ASSOCIATES, INC.
Doing business as
Promontory Family Vision
Practice address
5331 Adams Ave Pkwy Ste B
Ogden, UT 84405-4755
Phone
(385) 626-7699
Fax
(385) 626-7816
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Spring Deroche
Title
Office Manager
Phone
(385) 626-7699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 375535-9934 UT Primary

Addresses

Primary practice location

5331 Adams Ave Pkwy Ste B
Ogden, UT 84405-4755

Mailing address

5331 Adams Ave Pkwy Ste B
Ogden, UT 84405-4755
Phone (385) 626-7699

Other identifiers 1

IdentifierTypeStateIssuer
529378983004MedicaidUT

Other names 1

  • Promontory Family Vision Doing business as

National Provider Directory

National Provider Directory

Locations

124 S Fairfield Rd
Ste A105
Layton, UT 84041

5331 Adams Avenue Pkwy
Ste B
Washington Terrace, UT 84405
Phone (801) 479-7850

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1871696179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 ADAMS AVE PKWY STE B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054755",
            "telephone_number": "385-626-7699",
            "fax_number": "385-626-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 ADAMS AVE PKWY STE B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054755",
            "telephone_number": "385-626-7699",
            "fax_number": "385-626-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL M JUDKINS AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "DEROCHE",
        "authorized_official_first_name": "SPRING",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "385-626-7699"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "375535-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529378983004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promontory Family Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Promontory Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.