Ryan J. Mortensen, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

5898711-9934 Issued in UT

Legal business name

RYAN J. MORTENSEN, INC

Doing business as

District Vision Care

Practice address

11506 S District Dr Ste 400
South Jordan, UT 84095-5769

Phone

(801) 495-4833

NPI assigned

Jan 25, 2016

Last updated

Jan 25, 2016By 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

Ryan Mortensen, O.D.NPI 1003818576

Title

Doctor

Phone

(801) 495-4833

Specialties & licenses 1

Addresses

Other names 1

• District Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

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.

• Ryan J Mortensen, O.D.

  • Optometrist
  • South Jordan, UT
  • NPI 1003818576
  Medicare reassignment NPD Authorized official
• Kurt Perry Hepworth, O.D

  • Optometrist
  • South Jordan, UT
  • NPI 1457531428
  NPD (past)

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1932566726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11506 S DISTRICT DR STE 400",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955769",
            "telephone_number": "801-495-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11506 S DISTRICT DR STE 400",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955769",
            "telephone_number": "801-495-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN J. MORTENSEN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "801-495-4833",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5898711-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "District Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna Renee Royall
• Kaylee Del Rudd, MFT
• Steven Eric Rush
• Laura Renay Russell, CMHC
• Bergen D Russon
• Rainey Rymer
• Mindy Meyers Saari, LCSW
• Samantha Sadlier, CSW
• Sage Counseling & Consulting
• Nathan A. Sager, CRNA

• Optometrist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.