Jacqueline Agnes Jennings, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2145DT Issued in KY

Practice address

1917 S Highway 53
La Grange, KY 40031-8512

Phone

(502) 225-0301

NPI assigned

Jul 5, 2019

Last updated

Oct 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Grimm Former name

Medicare fee-for-service enrollment

Enrolled in TX, KY2 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

Specialty

Optometry

Education

University of Alabama School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gaddie Eye Centers LLCGroup PAC ID 6103898895, 8 clinicians

Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelinegrimm@direct.eyecare-partners.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gaddie Eye Centers, LLC

  • Optometrist
  • Louisville, KY
  • NPI 1790759884
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Centerville, OH
  • NPI 1073917597

  KY

  Medicare reassignment Care Compare group NPD
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Clarkson Optometry Midwest Inc

  dba Clarkson Eyecare

  • Optometrist
  • Clarksville, IN
  • NPI 1295772143
  NPD
• DHHS, PHS, Naihs, Gallup Indian Medical Center

  dba Tohatchi Health Center

  • Federal Public Health Clinic/Center
  • Tohatchi, NM
  • NPI 1902875594
  NPD
• 20-20 Eyecare PSC

  • Optometrist
  • Louisville, KY
  • NPI 1710924949
  NPD (past)

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1245892645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 S HIGHWAY 53",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400318512",
            "telephone_number": "502-225-0301",
            "fax_number": "502-222-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 S HIGHWAY 53",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400318512",
            "telephone_number": "502-225-0301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7635 Shelbyville Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402225409",
            "country_code": "US",
            "telephone_number": "502-423-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9850 Von Allmen Ct",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402412854",
            "country_code": "US",
            "telephone_number": "502-429-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JACQUELINE",
        "middle_name": "AGNES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2145DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "GRIMM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eugene E Jacob, M.D.
• Sarah Jacobson, PHARMD
• Molly James
• Tarah Winter Jasper, APRN PMHNP
• Valentina Jenkins, APRN
• Tracy C Jensen, APRN
• Katherine Hartigan Jett, M.D.
• Holly Johns
• Dionna Johnson
• Joshua Jones, PHARMD

• Optometrist in La Grange, KY
• Providers in La Grange, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.