NPIMap

Organization Active NPI

Jimmerson Eyecare

Doing business as Center Eye Care

  • Optometrist
  • North Reading, MA
National Provider Identifier
1154835114
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4947 Issued in MA
Legal business name
JIMMERSON EYECARE
Doing business as
Center Eye Care
Practice address
162 Park St Ste 201
North Reading, MA 01864-2346
Phone
(813) 389-2854
NPI assigned
Nov 28, 2017
Last updated
Nov 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2017

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

Authorized official

Name
Dr. Jonathon Hudson Jimmerson, ODNPI 1972853554
Title
Owner / Optometrist
Phone
(813) 389-2854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4947 MA Primary

Addresses

Primary practice location

162 Park St Ste 201
North Reading, MA 01864-2346

Mailing address

1276 Boylston St
Newton, MA 02464-1019
Phone (813) 389-2854

Other names 1

  • Center Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180409000643 MA Part B Supplier - Clinic/Group Practice 9133482912 Receives reassigned benefits from 2 practitioners
Practice locations: North Reading, MA

National Provider Directory

National Provider Directory

Locations

115 Newbury St
Boston, MA 02116
Phone (617) 725-1921

162 Park St
North Reading, MA 01864

162 Park St
Ste 201
North Reading, MA 01864
Phone (978) 276-1111

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1154835114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 BOYLSTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641019",
            "telephone_number": "813-389-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 PARK ST STE 201",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018642346",
            "telephone_number": "813-389-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMERSON EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "JIMMERSON",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_middle_name": "HUDSON",
        "authorized_official_title_or_position": "OWNER / OPTOMETRIST",
        "authorized_official_telephone_number": "813-389-2854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.