Individual provider Active NPI

Sherrall Lecella Jenkins, OD

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1225849268
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11565 Issued in TX
Practice address
12457 Timberland Blvd Ste 201
Fort Worth, TX 76244-5211
Phone
(817) 741-4177
NPI assigned
Jan 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1113 MS
Optometrist 152W00000X 11565 TX Primary

Addresses

Primary practice location

12457 Timberland Blvd Ste 201
Fort Worth, TX 76244-5211

Mailing address

12457 Timberland Blvd Ste 201
Fort Worth, TX 76244-5211
Phone (817) 741-4177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250709001254 MS Practitioner - Optometry 1850805136 Reassigns benefits to 2 organizations
I20260423000452 TX Practitioner - Optometry 1850805136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians
Mississippi Eye Care of HazlehurstGroup PAC ID 4284897026, 2 clinicians

Practice addresses (Care Compare)

12457 Timberland Blvd
Suite 201
Fort Worth, TX 76244-5211
Phone (817) 741-4177

28063 Hwy 28
Suite C
Hazlehurst, MS 39083-2240
Phone (601) 894-2822

310 W Woodrow Wilson Ave
Suite 300
Jackson, MS 39213-7662

310 W Woodrow Wilson Ave
Suite 300
Jackson, MS 39213-7697
Phone (601) 366-9020

8329 Whitley Rd
Watauga, TX 76148-2483
Phone (817) 431-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11565TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Eye Care of Hazlehurst Optometrist CurrentSince Apr 28, 2025 Accepting new patients
Mississippi Eye Care Associates of Jackson, PLLC Optometrist CurrentSince Jul 5, 2025 Accepting new patients

Locations

7118 S Siwell Rd
#B
Byram, MS 39272
Phone (601) 373-0354

28063 Highway 28
#C
Hazlehurst, MS 39083
Phone (601) 894-2822

310 W Woodrow Wilson Ave
Ste 300
Jackson, MS 39213
Phone (601) 366-9020

Organizations & group practices 3

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": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1225849268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12457 TIMBERLAND BLVD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445211",
            "telephone_number": "817-741-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12457 TIMBERLAND BLVD STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445211",
            "telephone_number": "817-741-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SHERRALL",
        "middle_name": "LECELLA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1113",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.