UTAH VISION DEVELOPMENT CENTER, LLC
NPI 1104123801
Optometrist in South Jordan, UT
About Utah Vision Development Center, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UTAH VISION DEVELOPMENT CENTER, LLC (NPI 1104123801) is a healthcare organization registered as an optometrist in South Jordan, Utah and active in the NPI registry since February 2011. The organization lists Jarrod Davies, Optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Utah Vision Development Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Utah Vision Development Center, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
South Jordan, UT 84009
South Jordan, UT 84009
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Utah Vision Development Center, LLC's NPI number?
The NPI number for Utah Vision Development Center, LLC is 1104123801. It was assigned to this organization in the NPPES registry on February 16, 2011.
Where is Utah Vision Development Center, LLC located?
Utah Vision Development Center, LLC is located at 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009. The listed phone number is (801) 810-1060.
What is Utah Vision Development Center, LLC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Utah Vision Development Center, LLC enrolled in Medicare?
Yes. Utah Vision Development Center, LLC is registered in the Medicare PECOS enrollment system.
When is Utah Vision Development Center, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Utah, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Utah Vision Development Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Utah Vision Development Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Utah Vision Development Center, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee and 1 other insurer list Utah Vision Development Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Utah Vision Development Center, LLC was last updated on June 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Utah Vision Development Center, Llc · NPI 1104123801
Optometrist organization in South Jordan, Utah. Organization record, active in the CMS NPPES registry since February 16, 2011.
## Identity
- **NPI:** 1104123801 (Entity type: Organization)
- **Enumerated:** February 16, 2011
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Jarrod Davies, OPTOMETRIST
## Practice location
- **Address:** 3672 W SOUTH JORDAN PKWY, STE 103, South Jordan, UT 84009-7171
- **Phone:** (801) 810-1060
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Utah, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 2, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1104123801) · Data from the CMS NPPES public registry.