Individual provider Active NPI

Kenneth Walker Jarrett, OD

  • Optometrist
  • Monticello, AR
National Provider Identifier
1063082907
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2822 Issued in AR
Practice address
408 W McCloy St
Monticello, AR 71655-4325
Phone
(870) 367-8511
Fax
(870) 367-3215
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2822 AR Primary

Addresses

Primary practice location

408 W McCloy St
Monticello, AR 71655-4325

Mailing address

408 W McCloy St
Monticello, AR 71655-4325
Phone (870) 367-8511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210720001108 AR Practitioner - Optometry 8527461102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seark Eyecare LLCGroup PAC ID 3375810260, 3 clinicians

Practice addresses (Care Compare)

408 W McCloy St
Monticello, AR 71655-4325
Phone (870) 367-8511

Merit-based Incentive Payment System (MIPS)

Final score
92.79 of 100Reported as group
Quality
85.58
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2822ARMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ricky Ferguson Vision Center PA Optometrist CurrentSince Jul 4, 2021 Accepting new patients
Seark Eyecare LLC Optometrist CurrentSince Jul 12, 2021 Accepting new patients

Locations

408 W McCloy St
Monticello, AR 71655
Phone (870) 367-8511

Organizations & group practices 2

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": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1063082907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W MCCLOY ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554325",
            "telephone_number": "870-367-8511",
            "fax_number": "870-367-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W MCCLOY ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554325",
            "telephone_number": "870-367-8511",
            "fax_number": "870-367-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT",
        "first_name": "KENNETH",
        "middle_name": "WALKER",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

Verify at the official NPI Registry.