Organization Active NPI

Jason Jahn OD PC

  • Optometrist
  • Brookings, SD
National Provider Identifier
1174766430
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
142 Issued in SD
Legal business name
JASON JAHN OD PC
Practice address
1100 6TH St
Brookings, SD 57006-2206
Phone
(605) 692-2020
Fax
(605) 692-9594
NPI assigned
Apr 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Dr. Jason C Jahn, O.D.
Title
Owner
Phone
(605) 692-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 142 SD Primary

Addresses

Primary practice location

1100 6TH St
Brookings, SD 57006-2206

Mailing address

1100 6TH St
Brookings, SD 57006-2206
Phone (605) 692-2020

Other identifiers 6

IdentifierTypeStateIssuer
9201102MedicaidSD
P00084283OtherSDRAILROAD MEDICARE
22104OtherSDSIOUX VALLEY HEALTH
4C035JAOtherMNBCBS OF MN
0073102OtherSDBCBS OF SD
419OtherSDDAKOTA CARE

National Provider Directory

National Provider Directory

Locations

1100 6th St
Brookings, SD 57006
Phone (605) 692-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1174766430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062206",
            "telephone_number": "605-692-2020",
            "fax_number": "605-692-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 6TH ST",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062206",
            "telephone_number": "605-692-2020",
            "fax_number": "605-692-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON JAHN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "JAHN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-692-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SD",
            "license": "142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201102",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00084283",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH",
            "identifier": "22104",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "4C035JA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SD",
            "identifier": "0073102",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "419",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.