DR. JEFFREY L BROADHEAD (NPI# 1306829569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306829569 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY L BROADHEAD |
| Credential | O.D. |
| Practice Address |
3556 W 9800 S Suite 104 South Jordan UT 84095-3211 |
| Practice Telephone | 8012536590 |
| Practice Fax Number | 8012536591 |
| Mailing Telephone | 8012536590 |
| Mailing Fax Number | 8012536591 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2015-06-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4826018-9934 | UT | Eye and Vision Services Providers |
| Street Address |
3556 W 9800 S SUITE 104 |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104117381 | Michelle Elizabeth Murray | Internal Medicine | 3556 W 9800 S, Suite 101, South Jordan, UT 84095-3211 | 2011-04-22 |
| 1265606735 | Curtis K Andrews | Internal Medicine | 3556 W 9800 S, Suite 101, South Jordan, UT 84095-3211 | 2008-04-16 |
| 1922282599 | Progressive Eye Care, LLC | Optometrist | 3556 W 9800 S, Suite 104, South Jordan, UT 84095-3211 | 2007-12-19 |
| 1033329669 | Timothy B. Elison | Dentist | 3556 W 9800 S, Suite 103, South Jordan, UT 84095-3211 | 2007-05-23 |
| 1245440478 | Kevin Cottle | Nurse Practitioner | 3556 W 9800 S, Suite 101, South Jordan, UT 84095-3211 | 2007-05-23 |
| 1811057995 | Orthodontic Center | Dentist | 3556 W 9800 S, Suite 103, South Jordan, UT 84095 | 2006-12-11 |
| 1316970924 | Copperview Medical Center, LLC | Family Medicine | 3556 W 9800 S, 101, South Jordan, UT 84095-3211 | 2006-07-08 |
| 1669400552 | Sheri L Vlam | Nurse Practitioner | 3556 W 9800 S, # 101, South Jordan, UT 84095-3211 | 2006-06-29 |
| 1922065598 | Mary D Tipton | Pediatrics | 3556 W 9800 S, #101, South Jordan, UT 84095-3211 | 2006-04-27 |
| 1821054842 | Martin A Hollingsworth | Internal Medicine | 3556 W 9800 S, #101, South Jordan, UT 84095-3211 | 2006-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| 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 |
|---|---|---|---|---|
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1235697632 | Jeff Simmons Od, Pllc | Optometrist | 5474 W Daybreak Pkwy Ste G3, South Jordan, UT 84009-5909 | 2019-03-05 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1114377165 | Standard Optical Co | Optometrist | 11514 S 4000 W, Bldg H Suite 103, South Jordan, UT 84009-6014 | 2016-06-20 |
| 1932566726 | Ryan J. Mortensen, Inc | Optometrist | 11506 S District Dr Ste 400, South Jordan, UT 84095-5769 | 2016-01-25 |
| 1285927129 | Wasatch View Eye Care | Optometrist | 1218 W South Jordan Pkwy, Suite A, South Jordan, UT 84095-5517 | 2011-05-25 |
| 1801127634 | Wasatch View Eye and Laser Clinic LLC | Optometrist | 922 Baxter Dr, 110, South Jordan, UT 84095-8613 | 2010-01-19 |
| 1457531428 | Kurt Perry Hepworth | Optometrist | 11506 South District Main Dr. #400, South Jordan, UT 84095 | 2007-11-07 |
| 1730210683 | Apple Vision | Optometrist | 10498 S Redwood Rd, South Jordan, UT 84095-8501 | 2007-03-09 |
| 1699864801 | Shelly L Nielsen | Optometrist | 3571 West 10400 South, South Jordan, UT 84095 | 2006-10-12 |
| Find all providers in SOUTH JORDAN | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
Please comment or provide details below to improve the information on DR. JEFFREY L BROADHEAD.
| 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.