Jerome WH Niswonger MD Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

JEROME WH NISWONGER MD INC

Doing business as

Eye Life Institute

Practice address

245 N Villa Ave
Willows, CA 95988-2607

Phone

(530) 877-2020

Fax

(530) 877-4641

NPI assigned

Jul 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Niswonger, M.D.

Title

Owner

Phone

(530) 877-2020

Specialties & licenses 1

Addresses

Other names 1

• Eye Life Institute Doing business as

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1093979536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 CLARK RD",
            "address_2": "STE. 10",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959694100",
            "telephone_number": "530-877-2020",
            "fax_number": "530-877-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N VILLA AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882607",
            "telephone_number": "530-877-2020",
            "fax_number": "530-877-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME WH NISWONGER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "NISWONGER",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-877-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Life Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ophthalmology Physician in Willows, CA
• Providers in Willows, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.