Active NPI
James E Jackson, OD
- Optometrist
- Lafayette, CO
National Provider Identifier
1114022142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1558
- Practice address
- 1120 W South Boulder Road
Suite 102
Lafayette, CO 80026 - Phone
- (303) 665-7577
- Fax
- (303) 665-3633
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1558 | CO | Primary |
Addresses
Primary practice location
1120 W South Boulder Road
Suite 102
Lafayette, CO 80026
Mailing address
446 Blue Lake Trail
Lafayette, CO 80026
Phone (720) 890-7443
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1558 | CO | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114022142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446 BLUE LAKE TRAIL",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "80026",
"telephone_number": "720-890-7443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 W SOUTH BOULDER ROAD",
"address_2": "SUITE 102",
"city": "LAFAYETTE",
"state": "CO",
"postal_code": "80026",
"telephone_number": "303-665-7577",
"fax_number": "303-665-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JAMES",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CO
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.