Jason D Barlock

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN15803 Issued in FL

Practice address

8595 College Pkwy
Suite B-5
Fort Myers, FL 33919-5191

Phone

(239) 433-0921

NPI assigned

Feb 5, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 27, 2017 through Apr 27, 2027

Medicare enrollment (NPD)

Not 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.

• Alan D Shoopak DMD Orthodontic Group I LLC

  dba Orthodontic Specialists of Florida

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Myers, FL
  • NPI 1487789475
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093854481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15241 CORTONA WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341200673",
            "telephone_number": "239-776-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8595 COLLEGE PKWY",
            "address_2": "SUITE B-5",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195191",
            "telephone_number": "239-433-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARLOCK",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN15803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desirae Lin Barker, MA92872
• Barkley Circle Dental Center
• Barkley Healthcare Group LLC
• Barkley Surgicenter, LLC
• Kory Andrew Barkley, M.D.
• Brandon James Barnes, MD
• Cameron Miller Barnes, PA-C
• Andrea A Barnola Melendez
• Allison Barnum
• Christopher William Barr

• Orthodontics and Dentofacial Orthopedics Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.