Gloria C Jennings OD, Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001957 Issued in IN

Legal business name

GLORIA C JENNINGS OD, PROFESSIONAL CORPORATION

Practice address

1717 W 86TH St
Suite 130
Indianapolis, IN 46260-2050

Phone

(317) 876-1112

Fax

(317) 876-2187

NPI assigned

Jul 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Gloria C Jennings, O.D.

Title

Optometrist

Phone

(317) 876-1112

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1063642189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W 86TH ST",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602050",
            "telephone_number": "317-876-1112",
            "fax_number": "317-876-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W 86TH ST",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602050",
            "telephone_number": "317-876-1112",
            "fax_number": "317-876-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA C JENNINGS OD, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "317-876-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.