Jackson Family Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002717 Issued in GA

Legal business name

JACKSON FAMILY EYE CARE, LLC

Practice address

5370 Campbellton Fairburn Rd
410
Fairburn, GA 30213-2296

Phone

(972) 689-6722

NPI assigned

Nov 3, 2014

Organization subpart

No

Name

Dr. Danielle Nicole Jackson, ODNPI 1043568413

Title

Owner/ Optometrist

Phone

(972) 689-6722

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle Nicole Jackson, O.D.

  • Optometrist
  • East Point, GA
  • NPI 1043568413

  GA, Optometrist

  Medicare reassignment NPD Authorized official
• Nicole Akpunku, OD

  • Optometrist
  • Alpharetta, GA
  • NPI 1881180628
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in GA

Locations

• Jackson Eye Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2015.

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1235534207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5370 CAMPBELLTON FAIRBURN RD",
            "address_2": "410",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132296",
            "telephone_number": "972-689-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5370 CAMPBELLTON FAIRBURN RD",
            "address_2": "410",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132296",
            "telephone_number": "972-689-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/ OPTOMETRIST",
        "authorized_official_telephone_number": "972-689-6722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shaquonza Houston
• Roderick Elliott Howard, AM
• Terrell Humphries
• I Deserve Mental Wellness Services
• Independent Physical Therapy, LLC
• Chemara Jackson, ED.D., LPC
• Trevis Shantell Jackson
• Jeane Watson DPM LLC
• Kendra Jenkins
• Jervon D Hamilton Counseling

• All providers in Fairburn, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.