NPIMap

Organization Active NPI

Utah Valley Eye Center Inc

  • Specialist
  • Provo, UT
National Provider Identifier
1902195605
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1550231205 Issued in UT
Legal business name
UTAH VALLEY EYE CENTER INC
Practice address
1055 N 300 W Ste 204
Provo, UT 84604-3374
Phone
(801) 357-7373
Fax
(801) 357-7217
NPI assigned
Apr 4, 2011
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Mr. Michael Clayton
Title
Administrator
Phone
(801) 357-7373

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1109409934 UT
Optometrist 152W00000X 1131489934 UT
Specialist 174400000X 1550231205 UT Primary
Specialist 174400000X 1709201205 UT
Specialist 174400000X 1827901205 UT
Specialist 174400000X 49624391205 UT
Specialist 174400000X 72173901205 UT

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
O20110913000858 UT Part B Supplier - Clinic/Group Practice 7810167392 Receives reassigned benefits from 15 practitioners
Practice locations: Provo, UT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Utah Valley Eye Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1902195605",
    "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": "UTAH VALLEY EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-357-7373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1109409934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "1131489934",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "1550231205",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "1709201205",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "1827901205",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "49624391205",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "72173901205",
            "primary": false
        }
    ],
    "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 Sep 29, 2011; 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.