Jason Evans OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1637DT Issued in KY

Legal business name

JASON EVANS OD LLC

Practice address

470 N Mayo TRL
Paintsville, KY 41240-1806

Phone

(606) 789-0343

NPI assigned

Jan 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jason Marion Evans, OD

Title

Optometrist

Phone

(606) 789-0343

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1023294303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1301",
            "city": "INEZ",
            "state": "KY",
            "postal_code": "412241301",
            "telephone_number": "606-789-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 N MAYO TRL",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401806",
            "telephone_number": "606-789-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON EVANS OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MARION",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "606-789-0343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1637DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77001410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.