Organization Active NPI

Larry Noble, M.D., M.P.H., P.C.

  • Ophthalmology Physician
  • Provo, UT
National Provider Identifier
1871806646
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1487271205 Issued in UT
Legal business name
LARRY NOBLE, M.D., M.P.H., P.C.
Practice address
1055 N 300 W Ste 204
Provo, UT 84604-3374
Phone
(801) 357-7373
Fax
(801) 357-7217
NPI assigned
Jul 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Authorized official

Name
Dr. Larry Noble, M.D.NPI 1588734537
Title
Ophthalmologist/Owner
Phone
(801) 357-7373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 1487271205 UT Primary

Addresses

Primary practice location

1055 N 300 W Ste 204
Provo, UT 84604-3374

Mailing address

1055 N 300 W Ste 204
Provo, UT 84604-3374
Phone (801) 357-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100811000429 UT Part B Supplier - Clinic/Group Practice 3173657277 Receives reassigned benefits from 1 practitioner
Practice locations: Provo, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1871806646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 204",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043374",
            "telephone_number": "801-357-7373",
            "fax_number": "801-357-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 204",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043374",
            "telephone_number": "801-357-7373",
            "fax_number": "801-357-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY NOBLE, M.D., M.P.H., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST/OWNER",
        "authorized_official_telephone_number": "801-357-7373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "1487271205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.