Individual provider Active NPI

Janessa Marie Simon, O.D.

  • Optometrist
  • Greenville, OH
National Provider Identifier
1053644575
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5889 Issued in OH
Practice address
5735 Meeker Rd
Greenville, OH 45331-1180
Phone
(937) 548-3806
Fax
(937) 548-3552
NPI assigned
Sep 16, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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 5889 OH Primary

Addresses

Primary practice location

5735 Meeker Rd
Greenville, OH 45331-1180

Mailing address

5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 548-3806

Other practice location 1

1089 Fairington Dr
Sidney, OH 45365-8130
Phone (937) 492-9197

Other identifiers 1

IdentifierTypeStateIssuer
3031249MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091223000025 OH Practitioner - Optometry 5294875258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 548-9680

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services of Darke County Inc Current Accepting new patients
Family Health Services of Darke County, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Family Health Services of Darke County, Inc. CurrentSince Aug 1, 2017 Accepting new patients
J. Terebuh MD Inc Optometrist PastSince Jan 1, 1999 Accepting new patients
Family Health Services of Darke County Inc Past Accepting new patients

Locations

1101 Jackson St
Ste C
Greenville, OH 45331
Phone (937) 547-2319

5735 Meeker Rd
Greenville, OH 45331
Phone (937) 548-3806

Interoperability endpoints

  • Direct secure messaging: janessa.simon@fhsi.eclinicaldirectplus.com
  • Direct secure messaging: jsimon@directaddress.net

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053644575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-548-3806",
            "fax_number": "937-548-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-548-3806",
            "fax_number": "937-548-3552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1089 Fairington Dr",
            "address_purpose": "LOCATION",
            "city": "Sidney",
            "state": "OH",
            "postal_code": "453658130",
            "country_code": "US",
            "telephone_number": "937-492-9197",
            "fax_number": "937-492-7865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JANESSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3031249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

Verify at the official NPI Registry.