Active NPI
Jan Richard Ferris, OD
- Optometrist
- Jackson, MI
National Provider Identifier
1063467686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2235
- Practice address
- 900 E Ganson St
Jackson, MI 49201-1700 - Phone
- (517) 789-6171
- Fax
- (517) 789-6200
- NPI assigned
- May 23, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2235 | MI | Primary |
Addresses
Primary practice location
900 E Ganson St
Jackson, MI 49201-1700
Mailing address
900 E Ganson St
Jackson, MI 49201-1700
Phone (517) 789-6171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 945036409 | Medicaid | MI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2235 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferris Optical Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Jackson, MI
- NPI 1619271996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293753600000",
"number": "1063467686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 E GANSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011700",
"telephone_number": "517-789-6171",
"fax_number": "517-789-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E GANSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011700",
"telephone_number": "517-789-6171",
"fax_number": "517-789-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRIS",
"first_name": "JAN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2010-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "2235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "945036409",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.