Active NPI
Jay Joseph McDonald, O.D.
- Optometrist
- Tamuning, GU
National Provider Identifier
1316908684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OL024
- Practice address
- 548 South Marine Corps Drive
Tamuning, GU 96913 - Phone
- (671) 646-5824
- Fax
- (671) 647-3546
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OL024 | GU | Primary |
Addresses
Primary practice location
548 South Marine Corps Drive
Tamuning, GU 96913
Mailing address
PO Box 6578
Tamuning, GU 96931-6578
Phone (671) 646-6956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OL024 | GU | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1316908684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6578",
"city": "TAMUNING",
"state": "GU",
"postal_code": "969316578",
"telephone_number": "671-646-6956",
"fax_number": "671-647-3546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "548 SOUTH MARINE CORPS DRIVE",
"city": "TAMUNING",
"state": "GU",
"postal_code": "96913",
"telephone_number": "671-646-5824",
"fax_number": "671-647-3546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "JAY",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GU",
"license": "OL024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.