Jordan E Gwaltney, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1744 Issued in KS

Practice address

2520 N 14TH Ave
Dodge City, KS 67801-2315

Phone

(620) 227-3071

Fax

(620) 227-6911

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Idocs of Dodge City PAGroup PAC ID 9830152578, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.82 of 100Reported as group

Quality

71.64

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drg@idocsdodgecity.eyefinity-direct.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Hospice of the Prairie, Inc.

  • Community Based Hospice Care Agency
  • Dodge City, KS
  • NPI 1861454118

  Corporate Director

  CMS ownership

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.

• Idocs of Dodge City, PA

  • Optometrist
  • Dodge City, KS
  • NPI 1588785786
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1023124989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 N 14TH AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012315",
            "telephone_number": "620-227-3071",
            "fax_number": "620-227-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 N 14TH AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012315",
            "telephone_number": "620-227-3071",
            "fax_number": "620-227-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWALTNEY",
        "first_name": "JORDAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Lee Goebel, PHARMD
• Golden Medical, Inc. (Golden Medical)
• Great Plains Vision LLC
• Jessica Grigoreva
• Kirk D Gross, MD
• Tawnya Jean Hamilton, ARNP, CCM
• Jie Hao, PT, DPT
• Thomas D Harmon, HIS
• Angela Dawn Harp, D.C.
• Patricia L Harrington, D.O.

• Optometrist in Dodge City, KS
• Providers in Dodge City, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.