Jeffrey Ian Wynn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000150 Issued in VA

Practice address

17614 Main St
Dumfries, VA 22026-2359

Phone

(703) 221-3575

Fax

(703) 221-4416

NPI assigned

Jan 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jeffrey I Wynn OD LTD

  • Optometrist
  • Dumfries, VA
  • NPI 1750512257
  NPD Authorized official

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1154301190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17614 MAIN ST",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262359",
            "telephone_number": "703-221-3575",
            "fax_number": "703-221-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17614 MAIN ST",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262359",
            "telephone_number": "703-221-3575",
            "fax_number": "703-221-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JEFFREY",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009203265",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie L Wilson, L.P.C., LMFT
• Sherry Windsor, RPRS
• James Winlack, MSN, PMHNP-BC
• Word Consulting LLC
• Brittnie Wynder
• June Bobrin Wynn, LCSW
• Lucy Xiao, NP
• Xinsheng Zhu, D.D.S., P.C.
• Zerline Chambers-Kersey MD PC
• Jinghua Zhang, D.D.S

• Optometrist in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.