Jackson Eye Care, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

375344-9934 Issued in UT

Legal business name

JACKSON EYE CARE, INC

Doing business as

BARRY JACKSON OD

Practice address

51 E 400 N
Suite 4a
Cedar City, UT 84720-2686

Phone

(435) 586-1500

Fax

(435) 865-0784

NPI assigned

Dec 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell B Jackson, OD

Title

Owner Operator

Phone

(435) 586-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BARRY JACKSON OD Doing business as

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1114100740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1574",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847211574",
            "telephone_number": "435-586-1500",
            "fax_number": "435-865-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 E 400 N",
            "address_2": "SUITE 4A",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847202686",
            "telephone_number": "435-586-1500",
            "fax_number": "435-865-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON EYE CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "435-586-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "375344-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528882505001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARRY JACKSON OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Cedar City, UT
• Providers in Cedar City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.