Active NPI
Jennifer Eady, LDO
- Optician
- Lakeland, FL
National Provider Identifier
1013799295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO4568
- Practice address
- 3501 S Florida Ave
Lakeland, FL 33803-4860 - Phone
- (863) 644-9461
- NPI assigned
- Oct 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO4568 | Primary |
Addresses
Primary practice location
3501 S Florida Ave
Lakeland, FL 33803-4860
Mailing address
3501 S Florida Ave
Lakeland, FL 33803-4860
Phone (863) 644-9461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1013799295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 S FLORIDA AVE",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338034860",
"telephone_number": "863-644-9461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 S FLORIDA AVE",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338034860",
"telephone_number": "863-644-9461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADY",
"first_name": "JENNIFER",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-20",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": "DO4568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.