DR. STEPHEN BROCKBANK (NPI# 1508973397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508973397 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN BROCKBANK |
| Credential | O.D. |
| Practice Address |
222 S Main St Suite 110 Salt Lake City UT 84101-2174 |
| Mailing Address |
2847 N 1050 E Lehi UT 84043-4033 |
| Practice Telephone | 8014562020 |
| Practice Fax Number | 8014562021 |
| Mailing Telephone | 8014562020 |
| Mailing Fax Number | 8014562021 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2013-06-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 5601485-9934 | UT | Eye and Vision Services Providers |
| Street Address |
222 S MAIN ST SUITE 110 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84101-2174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962856922 | Molly Aldridge | Developmental Therapist | 222 S Main St, 5th Floor, Salt Lake City, UT 84101-2174 | 2016-04-15 |
| 1790192235 | Healthworks Med Group of Utah P C | Clinic/Center | 222 S Main St, Salt Lake City, UT 84101-2174 | 2014-07-16 |
| 1750622742 | Marc B Gunderson | Social Worker | 222 S Main St, Suite 500, Salt Lake City, UT 84101-2174 | 2013-03-15 |
| 1609129386 | Wb Eyecare LLC | Optometrist | 222 S Main St, Suite 110, Salt Lake City, UT 84101-2174 | 2012-10-18 |
| 1992959985 | Luce Forte | Physician Assistant | 222 S Main St, 14th Floor, Salt Lake City, UT 84101-2174 | 2008-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053804237 | Holly Smith | Registered Nurse | 1020 S Main Street, Salt Lake City, UT 84101 | 2018-06-12 |
| 1174999627 | Justin Williams | Social Worker | 155 W. 300 S., Salt Lake City, UT 84101 | 2015-08-19 |
| 1902291842 | Daryl Ray Ezidore | Student in an Organized Health Care Education/Training Program | 100 South 344 East, Salt Lake City, UT 84101 | 2015-03-30 |
| 1104190859 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 50 S Main St Ste 115, Salt Lake City, UT 84101 | 2012-02-28 |
| 1366713307 | Gonstead Family Chiropractic | Chiropractor | 1154 S. 300 W., Suite C, Salt Lake City, UT 84101 | 2012-01-23 |
| 1659544880 | Jeffrey Daniel | Registered Nurse | 404 South 400 West, Salt Lake City, UT 84101 | 2008-04-09 |
| 1306030580 | Christopher Dean Chapman | Chiropractor | 345 W 100 S Ste 6c, Salt Lake City, UT 84101 | 2007-08-30 |
| 1689713497 | Walter Landon Bye | Dentist | 15 West South Temple, Gateway Tower West Suite 440, Salt Lake City, UT 84101 | 2007-02-06 |
| 1154403152 | Allison Miller Gardner | Physical Therapist | 84 West 700 South, Salt Lake City, UT 84101 | 2006-10-19 |
| 1780655407 | Frederick Van Der Veur | Social Worker | 1020 South Main Street, 242, Salt Lake City, UT 84101 | 2006-01-30 |
| Find all providers in zip 84101 | ||||
| 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 | 84101 |
Please comment or provide details below to improve the information on DR. STEPHEN BROCKBANK.
| 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.