Jessica Wei-Yee Chan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011197 Issued in IL

Practice address

2011 N Roan St
Johnson City, TN 37601-3130

NPI assigned

Jul 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Solo Eye Care & Eyewear Gallery, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1396968459
  Medicare reassignment
• Solo Eye Care University Village PLLC

  • Optometrist
  • Chicago, IL
  • NPI 1881834836
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1093201188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 W MONTROSE AVE UNIT 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131994",
            "telephone_number": "909-319-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JESSICA",
        "middle_name": "WEI-YEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koushick Chakraborty, OTR/L
• Kayla Chambers, RD
• Marcus Antonio (Tony) Chambers, LPN
• Patricia L Chambers, M.D.
• Champion Physical Therapy LLC Halls
• Shambhavi Chandraiah, M.D.
• Mark Wan Soo Chang, MD
• Ryan Russell Chaniott, LCSW
• Cameron Chase Chapman, LPC/MHSP (TEMP)
• Dawn R.B. Chapman, D.C.

• Optometrist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.