Active NPI
Jennifer Jung, O.D.
- Optometrist
- Las Vegas, NV
National Provider Identifier
1083870299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 773
- Practice address
- 6464 N Decatur Blvd
Attn: Optometrist Office
Las Vegas, NV 89131-2959 - Phone
- (702) 433-2010
- NPI assigned
- Aug 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 13523 | CA | |
| Optometrist | 152W00000X | 773 | NV | Primary |
Addresses
Primary practice location
6464 N Decatur Blvd
Attn: Optometrist Office
Las Vegas, NV 89131-2959
Mailing address
1665 Tristan Flower Ave
Las Vegas, NV 89183-7997
Phone (559) 288-7732
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 |
|---|---|---|---|
| 773 | NV | MD | Addiction (Substance Use Disorder) Counselor |
| 13523 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414022400000",
"number": "1083870299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 TRISTAN FLOWER AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891837997",
"telephone_number": "559-288-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6464 N DECATUR BLVD",
"address_2": "ATTN: OPTOMETRIST OFFICE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891312959",
"telephone_number": "702-433-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2014-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "13523",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.