Individual provider Active NPI

Jennifer Rae Schweitzer, O.D.

  • Optometrist
  • Spokane Valley, WA
National Provider Identifier
1154417038
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003332 Issued in WA
Practice address
20 N Evergreen Rd
#102
Spokane Valley, WA 99216-5083
Phone
(509) 924-5665
Fax
(509) 922-9812
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003332 WA Primary

Addresses

Primary practice location

20 N Evergreen Rd
#102
Spokane Valley, WA 99216-5083

Mailing address

20 N Evergreen Rd
#102
Spokane Valley, WA 99216-5083
Phone (509) 924-5665

Other identifiers 2

IdentifierTypeStateIssuer
P00978639OtherWARR MEDICARE
2023265MedicaidWA

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

LicenseStateTypeSpecialty
3332WAMDRehabilitation Chiropractor
OD00003332WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Burgerson Eyecare Services LLC Optometrist CurrentSince Jan 21, 2021 Accepting new patients

Locations

20 N Evergreen Rd
#102
Spokane Valley, WA 99216
Phone (509) 924-5665

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1154417038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N EVERGREEN RD",
            "address_2": "#102",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165083",
            "telephone_number": "509-924-5665",
            "fax_number": "509-922-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N EVERGREEN RD",
            "address_2": "#102",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992165083",
            "telephone_number": "509-924-5665",
            "fax_number": "509-922-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWEITZER",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00978639",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023265",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.