DR. JEDIDIAH DAVID SMITH (NPI# 1649603572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649603572 |
| Entity Type | Individual |
| Full Name | DR. JEDIDIAH DAVID SMITH |
| Credential | O.D. |
| Practice Address |
1818 S 300 W Salt Lake City UT 84115-1805 |
| Mailing Address |
1945 E Brandon Park Way Sandy UT 84092-5234 |
| Practice Telephone | 8014859715 |
| Mailing Telephone | 8018421728 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2016-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 9488924-9934 | UT | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | 046010703 | IL | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376693424 | Jedidiah T Smith | Chiropractor | 1732 Palma Dr Ste 104, Ventura, CA 93003-5796 | 2007-01-11 |
| 1013471465 | Jedidiah Smith | Case Manager/Care Coordinator | 13317 Se Powell Blvd, Portland, OR 97236-3335 | 2019-01-29 |
| Street Address |
1818 S 300 W |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821076555 | Nathan Ray Green | Optometrist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2006-01-03 |
| 1952810731 | Salt Lake City Eye Care, LLC | Optometrist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2017-09-25 |
| 1972022275 | Julie Phan | Pharmacist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2017-09-18 |
| 1427442037 | Costco Wholesale Corporation | Hearing Aid Equipment | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2015-03-20 |
| 1285025569 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2015-02-09 |
| 1497039945 | Bruce Hodgdon | Pharmacist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2011-10-03 |
| 1780975649 | John Heath | Pharmacist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2011-04-27 |
| 1477735710 | Nathan Green O.d., P.C. | Optometrist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2007-11-28 |
| 1285778753 | Dwayne Freebairn | Pharmacist | 1818 S 300 W, Salt Lake City, UT 84115-1805 | 2007-02-17 |
| 1356451983 | Costco Wholesale Corporation | Pharmacy | 1818 S 300 W, Salt Lake City, UT 84115 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532894 | Meagan Miles | Optometrist | 1752 W 400 N Apt B, Salt Lake City, UT 84116-3546 | 2020-06-08 |
| 1811558554 | Ryan Garber | Optometrist | 500 Foothill Dr Salt Lake City Ut 84148, Salt Lake City, UT 84148-0001 | 2019-06-24 |
| 1346703766 | National Vision Inc | Optometrist | 1140 E Brickyard Rd Ste 23, Salt Lake City, UT 84106-2557 | 2019-04-11 |
| 1831664580 | Rocky Mountain Optical and Eye Care LLC | Optometrist | 4400 S 700 E Ste 160, Salt Lake City, UT 84107-3053 | 2018-10-09 |
| 1891216909 | Stephen Nicholas Lundquist | Optometrist | 801 S 800 E, Salt Lake City, UT 84102-3515 | 2017-06-28 |
| 1831546118 | Jeffrey Lynn Simmons | Optometrist | 1919 E Brighton Ridge Dr, Salt Lake City, UT 84121-4886 | 2016-05-17 |
| 1679953400 | Wendy Nguyen | Optometrist | 500 Foothill Drive Salt Lake City, Salt Lake City, UT 84148-0001 | 2015-06-07 |
| 1780063784 | Kaeleen Franson | Optometrist | 250 S 300 E, Salt Lake City, UT 84111-2502 | 2015-05-22 |
| 1942437058 | Michael S Peterson, Od, PC | Optometrist | 1553 Gregson Ave, Salt Lake City, UT 84106-3419 | 2009-06-16 |
| 1427241843 | Paul C Bruderer Od, PC | Optometrist | 339 E 3900 S, Suite 150, Salt Lake City, UT 84107-1677 | 2007-08-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
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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.