Individual provider Active NPI

Jennifer Annon

  • Optometrist
  • Lancaster, OH
National Provider Identifier
1306244926
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6344 Issued in OH
Practice address
1635 River Valley Cir S
River Valley Mall
Lancaster, OH 43130-1465
Phone
(740) 654-9734
NPI assigned
Dec 12, 2014
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6344 OH Primary

Addresses

Primary practice location

1635 River Valley Cir S
River Valley Mall
Lancaster, OH 43130-1465

Mailing address

13461 Milnor Rd
Pickerington, OH 43147-9553
Phone (614) 620-0334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160510000838 OH Practitioner - Optometry 0042509366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6344OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Vision Care of Mount Vernon Inc Optometrist CurrentSince Jan 28, 2019 Accepting new patients
Primary Vision Care of Mount Vernon Inc Optometrist CurrentSince Jan 28, 2019 Accepting new patients

Locations

1684 Venture Dr
Ste A
Mount Vernon, OH 43050
Phone (740) 393-6010

926 N 21st St
Newark, OH 43055
Phone (614) 366-7341

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1306244926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13461 MILNOR RD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479553",
            "telephone_number": "614-620-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 RIVER VALLEY CIR S",
            "address_2": "RIVER VALLEY MALL",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301465",
            "telephone_number": "740-654-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.