Devon Paul Jarvis, O.D.
Individual provider Active NPI Optometrist · Willard, MO
NPI 1124069208 · NPPES record last updated May 9, 2008
Key facts
- NPI
- 1124069208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2005020864 (MO)
- Practice address
- 302 Procter Rd
Willard, MO 65781-9144 - Phone
- (417) 742-2733
- Fax
- (417) 742-2237
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
302 E Proctor Rd
Willard, MO 65781-9144
Phone (417) 742-2733
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 19 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050913000358 | MO | Practitioner - Optometry | 6901839786 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005020864 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jarvis Family Eye Center, LLC | Optometrist | Current |
Accepting new patients |
Locations
302 Procter Rd
Willard, MO 65781
Phone (417) 742-2733
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2005020864 | MO | Yes |
Addresses
Primary practice location
302 Procter Rd
Willard, MO 65781-9144
Mailing address
302 Procter Rd
Willard, MO 65781-9144
Phone (417) 742-2733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 317178408 | Medicaid | MO |
Other providers in Willard, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.