NPIMap

Organization Active NPI

Jennifer Wandell

Doing business as Eye to Eye Vision Care

  • Optometrist
  • Slidell, LA
National Provider Identifier
1174652820
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1357 491T Issued in LA
Legal business name
JENNIFER WANDELL
Doing business as
Eye to Eye Vision Care
Practice address
1076 Clipper Drive
Slidell, LA 70458
Phone
(504) 813-5938
NPI assigned
Mar 5, 2007
Last updated
Jul 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Jennifer Wandell, OD
Title
Optometrist
Phone
(504) 813-5938

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1357 491T LA Primary

Addresses

Primary practice location

1076 Clipper Drive
Slidell, LA 70458

Mailing address

1076 Clipper Drive
Slidell, LA 70458
Phone (504) 813-5938

Other identifiers 2

IdentifierTypeStateIssuer
1265523278OtherLANPI FOR JENNIFER WANDELL
1475831MedicaidLA

Other names 1

  • EYE TO EYE VISION CARE Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1174652820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 CLIPPER DRIVE",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "504-813-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 CLIPPER DRIVE",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "504-813-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER WANDELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "WANDELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "504-813-5938",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1357 491T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR JENNIFER WANDELL",
            "identifier": "1265523278",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1475831",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE TO EYE VISION CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.