Ja'Nai Xzana Tellis Frederick, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001758 Issued in VA

Practice address

9440 Iron Bridge Rd
Chesterfield, VA 23832-6601

Phone

(804) 748-4877

Fax

(804) 796-9168

NPI assigned

Sep 15, 2008

Last updated

Jul 19, 2022By 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

Medicare fee-for-service enrollment

Enrolled in VA

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Chesterfield Optometric Center, PC

  • Optometrist
  • Chesterfield, VA
  • NPI 1477698819
  Medicare reassignment NPD
• Roxann L. Robinson, O.D., P.C.

  • Optometrist
  • Midlothian, VA
  • NPI 1881741916
  NPD
• Redlands Optometry Group Inc a Professional Optometric Corporation

  dba Redlands Optometry Group

  • Optometrist
  • Redlands, CA
  • NPI 1467620062
  NPD (past)

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1265681332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1118",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238329123",
            "telephone_number": "804-748-4877",
            "fax_number": "804-796-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9440 IRON BRIDGE RD",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326601",
            "telephone_number": "804-748-4877",
            "fax_number": "804-796-9168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Nevada St",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923742956",
            "country_code": "US",
            "telephone_number": "909-793-2106",
            "fax_number": "909-792-3246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JA'NAI",
        "middle_name": "XZANA TELLIS",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasie Madison Fowler, M.S. CCC-SLP
• Valerie Fowlkes
• Demetrice Fox
• Suzanne Frailing-Saltisiak, LCSW
• Autumn Angel Frazier
• Fresh Start 4U LLC
• Robin L Friedman, M.D.
• Laura Fuentes, S.L.P.
• Gregory S Fulk, L.C.S.W.
• Kara Norment Fulop, LPC

• Optometrist in Chesterfield, VA
• Providers in Chesterfield, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.