Jerry Dale Warthman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002286 A Issued in IN

Practice address

1923 W 53Rd St
Anderson, IN 46013-1109

Phone

(765) 644-0060

Fax

(765) 644-0076

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University - School of Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jerry D Warthman, O.D., LLC

  • Optometrist
  • Anderson, IN
  • NPI 1053577510
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1063493906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 W 53RD ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131109",
            "telephone_number": "765-644-0060",
            "fax_number": "765-644-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 W 53RD ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131109",
            "telephone_number": "765-644-0060",
            "fax_number": "765-644-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARTHMAN",
        "first_name": "JERRY",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002286 A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100331000B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200953040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Walters
• Erin L Walton, BCBA
• Mallori Waltz, RBT
• Danille Ward
• Tanya J Warner
• Julia Lynn Washburn, B.S. M.A.
• Shirley A Washington-Burt
• Demaris F Watson
• Erin Michelle Watson, RN, FNP-C
• Christina Waymire

• Optometrist in Anderson, IN
• Providers in Anderson, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.