David R. Albrecht O.D. P.C.
Organization Active NPI Optometrist · Beaver, UT
NPI 1962845032 · NPPES record last updated May 3, 2013
Key facts
- NPI
- 1962845032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 347546-9934 (UT)
- Legal business name
- DAVID R. ALBRECHT O.D. P.C.
- Practice address
- 15 South 100 East
Beaver, UT 84713-0111 - Phone
- (435) 438-2020
- NPI assigned
- Apr 9, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. David Richard Albrecht, O.D.
- Title
- President
- Phone
- (435) 438-2020
Practitioners 14
-
David Richard Albrecht, O.D.
-
Julie Ann Carlisle, PSYD
-
Laurie Elkins, LCSW
-
Clay Frandsen, PHD
-
Austin C Haacke, AMFT
-
Jennifer Hanks, LCMHC
-
Thomas Kramer, PH.D.
-
Rachel Lynne Terrazas, MS, CMHC
-
Michael Cornel Thomas, APRN
-
Vaughn E Worthen, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130424001002 | UT | Part B Supplier - Clinic/Group Practice | 9335385087 |
Receives reassigned benefits from 1 practitioner Practice locations: Beaver, UT; Cedar City, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 347546-9934 | UT | Yes |
Addresses
Primary practice location
15 South 100 East
Beaver, UT 84713-0111
Mailing address
15 South 100 East
PO Box 111
Beaver, UT 84713-0111
Phone (435) 438-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529536175003 | Medicaid | UT |
Other names
- EyeTown
Other providers in Beaver, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.