Kirsten A Jervis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000126 Issued in PA

Practice address

10 Trieble Dr
Suite 3
Tunkhannock, PA 18657-7054

Phone

(570) 836-2020

Fax

(570) 836-5501

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Davis Charles Haire Sr., O.D.

  • Optometrist
  • Tunkhannock, PA
  • NPI 1184788267
  Medicare reassignment

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481328000000",
    "number": "1265474530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TRIEBLE DR",
            "address_2": "SUITE 3",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186577054",
            "telephone_number": "570-836-2020",
            "fax_number": "570-836-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRIEBLE DR",
            "address_2": "SUITE 3",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186577054",
            "telephone_number": "570-836-2020",
            "fax_number": "570-836-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERVIS",
        "first_name": "KIRSTEN",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald F Hull III, MD
• Ian a Kellman MD LLC
• Balsam Itani, DPT
• Elissa Lee Jacob
• Alfred Stephen Jaskulski, D.M.D.
• David Robert Jones, PA-C
• Elayne Kristen Jones, LPC
• Chris T Kalna, DMD
• Michael Robert Kapottos, DO
• Kara B Golden LLC

• Optometrist in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.