Individual provider Active NPI

Jeffrey Scott Foreman, O.D.

  • Optometrist
  • Fort Dodge, IA
National Provider Identifier
1205808359
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
01739 Issued in IA
Practice address
1511 1St Ave S
Fort Dodge, IA 50501-5012
Phone
(515) 955-7777
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 01739 IA Primary

Addresses

Primary practice location

1511 1St Ave S
Fort Dodge, IA 50501-5012

Mailing address

1511 1St Ave S
Fort Dodge, IA 50501-5012
Phone (515) 955-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100109000015 IA Practitioner - Optometry 6608917836 Practice locations: Fort Dodge, IA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01739IAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Heath Family Eyecare Inc Optometrist CurrentSince Oct 1, 2018 Accepting new patients

Locations

1511 1st Ave S
Fort Dodge, IA 50501
Phone (515) 955-7777

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1205808359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 1ST AVE S",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015012",
            "telephone_number": "515-955-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 1ST AVE S",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015012",
            "telephone_number": "515-955-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.