Individual provider Active NPI

Jan Clenney Lenz, O.D.

  • Optometrist
  • Sheffield, AL
National Provider Identifier
1215040944
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S704TA052 Issued in AL
Practice address
1110 S. Montgomery Ave
Tennessee River Eye Clinic
Sheffield, AL 35660
Phone
(256) 320-2020
Fax
(256) 381-7754
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S704TA052 AL Primary

Addresses

Primary practice location

1110 S. Montgomery Ave
Tennessee River Eye Clinic
Sheffield, AL 35660

Mailing address

1110 S. Montgomery Ave
Tennessee River Eye Clinic
Sheffield, AL 35660
Phone (256) 381-2020

Other identifiers 1

IdentifierTypeStateIssuer
207563MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20080630000168 AL Practitioner - Optometry 4587736954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee River Eye ClinicGroup PAC ID 9032392345, 2 clinicians

Practice addresses (Care Compare)

1110 S Montgomery Ave
Sheffield, AL 35660-6330
Phone (256) 381-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S704TA052ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee River Eye Clinic CurrentSince Nov 3, 2017 Accepting new patients
Parker Cornea PastSince Nov 3, 2017 Accepting new patients

Locations

1110 S Montgomery Ave
Sheffield, AL 35660
Phone (256) 320-2020

Interoperability endpoints

  • Direct secure messaging: janlenzod@tnrivereye.direct.eyemdemr.com

Organizations & group practices 2

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1215040944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S. MONTGOMERY AVE",
            "address_2": "TENNESSEE RIVER EYE CLINIC",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "35660",
            "telephone_number": "256-381-2020",
            "fax_number": "256-381-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S. MONTGOMERY AVE",
            "address_2": "TENNESSEE RIVER EYE CLINIC",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "35660",
            "telephone_number": "256-320-2020",
            "fax_number": "256-381-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENZ",
        "first_name": "JAN",
        "middle_name": "CLENNEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S704TA052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207563",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield, AL

Sources for this page

Verify at the official NPI Registry.