Gregory Donald Jones, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1908 Issued in MN

Practice address

Walmart Vision Ctr #2274
200 KSW 12TH St
Forest Lake, MN 55025-1609

Phone

(651) 464-9767

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Apolade Inc

  • Optometrist
  • Maple Grove, MN
  • NPI 1740313824
  NPD (past)
• DT Vision Care L.L.C.

  • Optometrist
  • Saint Cloud, MN
  • NPI 1760798441
  NPD (past)
• Thomas N Johnson Optometric Corp

  • Optometrist
  • Sauk Rapids, MN
  • NPI 1275772790
  NPD (past)
• Walmart Inc.

  • Community/Retail Pharmacy
  • Eastvale, CA
  • NPI 1770458945
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295829752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SOUTH SHORE DR",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251609",
            "telephone_number": "651-335-1846",
            "fax_number": "651-464-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALMART VISION CTR #2274",
            "address_2": "200 KSW 12TH ST",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550251609",
            "telephone_number": "651-464-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "GREGORY",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "1908",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1876",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "B19461046411",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202279",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C403JO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202278 THRU 2202296",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon Ronald Jirovec, MA, LADC
• Kollin B Johnson, DPT
• Kristi Leigh Johnson, MSW, LICSW
• Steven Z Johnson, D.C.
• Beth Diane Jones, MA, LMFT
• Nathaniel Lowell Joppa
• Jorja Jamison Counseling and Consulting LLC
• Eric Matthew Jundt, PT
• Julie Ann Kammer, MD
• Kari Clinic of Chiropractic, P.a.

• Optometrist in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.