Active NPI
Department of Ophthalmology
- Ophthalmology Physician
- South Jordan, UT
National Provider Identifier
1952652273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- DEPARTMENT OF OPHTHALMOLOGY
- Practice address
- 5126 W Daybreak Pkwy
South Jordan, UT 84095-5994 - Phone
- (801) 213-4500
- NPI assigned
- Sep 26, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Randall J Olson, MD
- Title
- Department Chair
- Phone
- (801) 587-6470
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Corneal and Contact Management Optometrist | 152WC0802X | |||
| Low Vision Rehabilitation Optometrist | 152WL0500X | |||
| Pediatric Optometrist | 152WP0200X | |||
| Sports Vision Optometrist | 152WS0006X | |||
| Vision Therapy Optometrist | 152WV0400X | |||
| Occupational Vision Optometrist | 152WX0102X | |||
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
5126 W Daybreak Pkwy
South Jordan, UT 84095-5994
Mailing address
PO Box 413075
Salt Lake City, UT 84141-3075
Phone (801) 213-3900
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1348617600000",
"number": "1952652273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 413075",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841413075",
"telephone_number": "801-213-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5126 W DAYBREAK PKWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840955994",
"telephone_number": "801-213-4500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DEPARTMENT OF OPHTHALMOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2012-09-26",
"last_updated": "2012-09-26",
"status": "A",
"authorized_official_last_name": "OLSON",
"authorized_official_first_name": "RANDALL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "DEPARTMENT CHAIR",
"authorized_official_telephone_number": "801-587-6470",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Corneal and Contact Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Sports Vision",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Vision Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Occupational Vision",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.