RETINAPRO, PC (NPI# 1104061167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104061167 |
| Entity Type | Organization |
| Organization Name | RETINAPRO, PC |
| Practice Address |
440 D St 210 Salt Lake City UT 84103-2817 |
| Practice Telephone | 8014083705 |
| Practice Fax Number | 8014083706 |
| Mailing Telephone | 8014083705 |
| Mailing Fax Number | 8014083706 |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2009-01-08 |
| Authorized Official Name | JEANNE HESS (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 8014083705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 5216808-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
440 D ST 210 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84103-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811028277 | Karin Ingrid Maria Westlen-boyer | Physical Therapist | 440 D St, #206, Salt Lake City, UT 84103-2817 | 2007-03-08 |
| 1396073276 | Ihc Health Services Inc. | Clinic/Center | 440 D St, Ste 206, Salt Lake City, UT 84103-2817 | 2009-12-03 |
| 1841528726 | Ihc Health Services Inc. | Clinic/Center | 440 D St, Ste 202, Salt Lake City, UT 84103-2817 | 2009-12-03 |
| 1174713978 | Ihc Health Services Inc | Radiology | 440 D St, #200, Salt Lake City, UT 84103-2817 | 2007-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932509213 | Paul David Rauch | Specialist/Technologist | 701 De Soto Street, Salt Lake City, UT 84103 | 2014-08-24 |
| 1073866695 | University Neuropsychiatric Institute | Community Based Residential Treatment Facility, Mental Illness | 252 South 500 East, Salt Lake City, UT 84103 | 2012-10-19 |
| 1114285558 | Christopher John Murphy | Student in an Organized Health Care Education/Training Program | 585 1st Ave, Salt Lake City, UT 84103 | 2012-04-23 |
| 1447573266 | Peter Louis Kapelke | Specialist | Fairfax Rd. @ Virginia St., Shriners Hospital Salt Lake City, Salt Lake City, UT 84103 | 2010-03-08 |
| 1578763389 | Susana Auhangamea Kinikini | Nurse Practitioner | Fairfax @ Virginia Street, Salt Lake City, UT 84103 | 2007-07-19 |
| 1609082320 | Cynthia N Shumway | Social Worker | 580 10th Avenue, Salt Lake City, UT 84103 | 2007-05-16 |
| 1811010655 | Kent Walker Farnsworth | Obstetrics & Gynecology | 1509 Federal Heights Drive, Salt Lake City, UT 84103 | 2007-04-09 |
| 1912082421 | Eloise Agnes Maughan | Nurse Practitioner | 324 8th Ave, Lds Hospital, Salt Lake City, UT 84103 | 2006-10-25 |
| 1407968464 | Kit D Smith | Anesthesiology | 359 - 8th Avenue, Asc, Salt Lake City, UT 84103 | 2006-08-31 |
| 1396854113 | Lisa H Carter | Physical Therapist | 1285 East Fairfax Road, Salt Lake City, UT 84103 | 2006-08-29 |
| Find all providers in zip 84103 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1699126680 | Judd Michael Cahoon | Ophthalmology | 3281 E Santa Rosa Ave, Salt Lake City, UT 84109-4128 | 2016-06-30 |
| 1356706469 | John Christian Nelson | Ophthalmology | 3449 South 4155 West, Salt Lake City, UT 84109-2468 | 2015-12-17 |
| 1558660308 | Brian E Zaugg | Ophthalmology | John A Moran Eye Center 65 Mario Capecchi Dr, Salt Lake City, UT 84132-0001 | 2011-03-18 |
| 1770880346 | Gary Ricks Jones | Ophthalmology | 1924 S View St, Salt Lake City, UT 84105-3712 | 2011-02-17 |
| 1861792665 | Susan Crawford Chortkoff | Ophthalmology | John A Moran Eye Ctr, 65 North Mario Capecchi Drive, Salt Lake City, UT 84132-0001 | 2010-10-26 |
| 1689991747 | Kian Eftekhari | Ophthalmology | Eyelid Center of Utah, 22 S 900 E, Salt Lake City, UT 84102 | 2010-04-29 |
| 1760621940 | Bryan Paul Hemard Sr. | Ophthalmology | 6308 Canyon Cove Dr, Salt Lake City, UT 84121-6336 | 2009-02-12 |
| 1689833436 | Surgical Care Associates | Ophthalmology | 1025 East 3300 South, Suite B, Salt Lake City, UT 84106-4389 | 2008-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.