Wayne D. Jenkins, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

CT2074 Issued in CT

Practice address

61 Westfarms Mall # D111
Farmington, CT 06032-2631

Phone

(860) 561-5687

Fax

(860) 561-8905

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

State licenses

Practice roles

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.

• Prudhomme Vision LLC

  • Optometrist
  • Manchester, CT
  • NPI 1649504432
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154470318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WESTFARMS MALL # D111",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322631",
            "telephone_number": "860-561-5687",
            "fax_number": "860-561-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WESTFARMS MALL # D111",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322631",
            "telephone_number": "860-561-5687",
            "fax_number": "860-561-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "WAYNE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Jauregui, CCP
• Homan Javaheri, D.M.D.
• Marian Alinet Javier Saldana, M.D
• Mark William Jay, LCSW
• Fabienne Jean, DO
• Jennie Song, Psy.D., LLC
• Jennifer J Stagg ND LLC
• Tiara Jennings, MD
• Haley Jensen, MD
• Candice G Jersey, D.O

• Optometrist in Farmington, CT
• Providers in Farmington, CT by specialty
• Optometrist in Connecticut

• 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.
• 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.