Individual provider Active NPI

Jody Lemarr-Cabano, OD

  • Optometrist
  • Corsicana, TX
National Provider Identifier
1003824723
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6404TG Issued in TX
Practice address
202 W 5TH Ave
Corsicana, TX 75110-5202
Phone
(903) 872-5681
Fax
(903) 872-0603
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6404TG TX Primary

Addresses

Primary practice location

202 W 5TH Ave
Corsicana, TX 75110-5202

Mailing address

202 W 5TH Ave
Corsicana, TX 75110-5202
Phone (903) 872-5681

Other identifiers 1

IdentifierTypeStateIssuer
355757ZG5ZMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060127000409 TX Practitioner - Optometry 7810901915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corsicana Envision Eyecare PAGroup PAC ID 0648484733, 2 clinicians

Practice addresses (Care Compare)

202 W 5TH Ave
Corsicana, TX 75110-5202
Phone (903) 872-5681

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6404TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Corsicana Envision Eyecare PA Optometrist CurrentSince Feb 8, 2014 Accepting new patients

Locations

202 W 5th Ave
Corsicana, TX 75110
Phone (903) 872-5681

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1003824723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W 5TH AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751105202",
            "telephone_number": "903-872-5681",
            "fax_number": "903-872-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W 5TH AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751105202",
            "telephone_number": "903-872-5681",
            "fax_number": "903-872-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMARR-CABANO",
        "first_name": "JODY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6404TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355757ZG5Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.