Individual provider Active NPI

Jan L. Moennig, OD

  • Optometrist
  • Clearwater, FL
National Provider Identifier
1235182478
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02200 Issued in FL
Practice address
900 N Belcher Rd
Clearwater, FL 33765-2105
Phone
(727) 447-5466
Fax
(727) 449-0616
NPI assigned
May 18, 2006
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02200 FL Primary

Addresses

Primary practice location

900 N Belcher Rd
Clearwater, FL 33765-2105

Mailing address

900 N Belcher Rd
Clearwater, FL 33765-2105
Phone (727) 447-5466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090803000082 FL Practitioner - Optometry 4385797745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02200FLMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1235182478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337652105",
            "telephone_number": "727-447-5466",
            "fax_number": "727-449-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337652105",
            "telephone_number": "727-447-5466",
            "fax_number": "727-449-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOENNIG",
        "first_name": "JAN",
        "middle_name": "L.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "02200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.