THE CHILDREN'S VISION CENTER LLC (NPI# 1174160170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174160170 |
| Entity Type | Organization |
| Organization Name | THE CHILDREN'S VISION CENTER LLC |
| Practice Address |
1490 E Foremaster Dr Ste 120 St George UT 84790-4493 |
| Mailing Address |
1038 S White Sands Dr Washington UT 84780-8202 |
| Practice Telephone | 4354291686 |
| Mailing Telephone | 4354291686 |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | JENNA O'BRIEN (OWNER) |
| Authorized Official Telephone | 4354291686 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 152WS0006X |
Optometrist Specialization: Sports Vision |
Eye and Vision Services Providers | ||
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
Eye and Vision Services Providers | ||
| Y | 152WP0200X |
Optometrist Specialization: Pediatrics |
Eye and Vision Services Providers |
| Street Address |
1490 E FOREMASTER DR STE 120 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-4493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427452325 | Jenna O'brien | Optometrist | 1490 E Foremaster Dr Ste 120, St George, UT 84790-4493 | 2014-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 152WP0200X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Pediatrics |
| Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740644301 | University of Utah Pediatric Services | Optometrist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-04-11 |
| 1578949699 | Duval and Price Eye Care | Optometrist | 3507 N University Ave Ste 225, Provo, UT 84604-6635 | 2015-07-31 |
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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.