Childers and Jackson Family Eye Care Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CHILDERS AND JACKSON FAMILY EYE CARE INC.

Practice address

723 Falls Blvd S
Ste a
Wynne, AR 72396-3508

Phone

(870) 238-9407

Fax

(870) 238-4320

NPI assigned

Oct 1, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Julia RM Jackson, O.D.NPI 1568627958

Title

Optometrist

Phone

(870) 238-9407

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julia Rebecca Meyer Jackson, O.D.

  • Optometrist
  • Wynne, AR
  • NPI 1568627958

  AR, Optometrist

  Medicare reassignment Care Compare group NPD Authorized official
• Eryn Brown, OD

  • Optometrist
  • Wynne, AR
  • NPI 1508755174

  AR, Optometrist

  Medicare reassignment Care Compare group NPD
• Ashley McGee, OD

  • Optometrist
  • Marion, AR
  • NPI 1932733185

  AR, Optometrist

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1003125535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 FALLS BLVD S",
            "address_2": "STE A",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963508",
            "telephone_number": "870-238-9407",
            "fax_number": "870-238-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 FALLS BLVD S",
            "address_2": "STE A",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963508",
            "telephone_number": "870-238-9407",
            "fax_number": "870-238-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDERS AND JACKSON FAMILY EYE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "RM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "870-238-9407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186236722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Chapman, COTA/L
• Brianna Nicole Chapman, COTA, L
• Michelle Frances Chapman, APRN
• Charlie'S Angels Transit, LLC
• Charlie'S Angels Transit, LLC
• Kerry K Childers, O.D.
• Madison Grace Coats
• Valisya Coleman, LCSW
• Kimberly Collins
• Tiffani Lynette Collins, COTA/L

• All providers in Wynne, AR
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.