Individual provider Active NPI

Jennifer Cherry Lane, OD

  • Optometrist
  • Newport News, VA
National Provider Identifier
1194980383
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001867 Issued in VA
Practice address
12130 Jefferson Avenue
Newport News, VA 23602
Phone
(757) 249-1324
Fax
(757) 249-1369
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001867 VA Primary

Addresses

Primary practice location

12130 Jefferson Avenue
Newport News, VA 23602

Mailing address

P.O. Box 1056
Suffolk, VA 23439-1056
Phone (757) 249-1324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090826000234 VA Practitioner - Optometry 5597810630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2401 Godwin Blvd
Suite 3
Suffolk, VA 23434-8178
Phone (757) 935-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer C Lane OD PLLC Optometrist CurrentSince Sep 22, 2015 Accepting new patients

Locations

12130 Jefferson Ave
Newport News, VA 23602
Phone (757) 234-7083

2401 Godwin Blvd
Ste 3
Suffolk, VA 23434
Phone (757) 923-9660

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1194980383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1056",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234391056",
            "telephone_number": "757-249-1324",
            "fax_number": "757-249-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 JEFFERSON AVENUE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23602",
            "telephone_number": "757-249-1324",
            "fax_number": "757-249-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JENNIFER",
        "middle_name": "CHERRY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.