Individual provider Active NPI

Jake Lumpkin, O.D.

  • Optometrist
  • Lakewood, CO
National Provider Identifier
1245756105
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003347 Issued in CO
Practice address
10705 W Colfax Ave
Lakewood, CO 80215-3813
Phone
(130) 344-5944
NPI assigned
Aug 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003347 CO Primary

Addresses

Primary practice location

10705 W Colfax Ave
Lakewood, CO 80215-3813

Mailing address

2870 Highway 69a
Camden, TN 38320-6190
Phone (731) 431-6078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20231227002442 CO Practitioner - Optometry 6709234545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10990 County Rd
Suite 28
Ovid, CO 80744-9430

1510 W Main St
Sterling, CO 80751-9095
Phone (970) 522-9192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003347COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Out There Eyecare LLC Optometrist CurrentSince Nov 21, 2023 Accepting new patients

Locations

1510 W Main St
Sterling, CO 80751
Phone (970) 522-8340

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1245756105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 HIGHWAY 69A",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383206190",
            "telephone_number": "731-431-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 W COLFAX AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802153813",
            "telephone_number": "130-344-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMPKIN",
        "first_name": "JAKE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.