Individual provider Active NPI

Jennifer Ann Floyd, OD

  • Vision Therapy Optometrist
  • Ruston, LA
National Provider Identifier
1174565295
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
LA1285-436T Issued in LA
Practice address
1010 S Vienna St
Ruston, LA 71270-5832
Phone
(318) 255-9433
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X LA1285-436T LA Primary

Addresses

Primary practice location

1010 S Vienna St
Ruston, LA 71270-5832

Mailing address

153 Johnston Rd
Choudrant, LA 71227-3479
Phone (318) 768-4410

Other identifiers 1

IdentifierTypeStateIssuer
1431362MedicaidLA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060221000611 LA Practitioner - Optometry 3476569997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 N Trenton St
Ruston, LA 71270-3805
Phone (318) 202-5845

Merit-based Incentive Payment System (MIPS)

Final score
14.32 of 100Reported as individual
Quality
25
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LA1285-436TLAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Visual Difference LLC Vision Therapy CurrentSince Dec 7, 2005 Accepting new patients

Locations

1010 S Vienna St
Ruston, LA 71270
Phone (318) 255-0817

303 N Trenton St
Ruston, LA 71270
Phone (318) 202-5845

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1174565295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 JOHNSTON RD",
            "city": "CHOUDRANT",
            "state": "LA",
            "postal_code": "712273479",
            "telephone_number": "318-768-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S VIENNA ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705832",
            "telephone_number": "318-255-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "LA",
            "license": "LA1285-436T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1431362",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.