Jennifer Street Childers, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

855 Issued in MS

Practice address

1010B City Ave N
Ripley, MS 38663-1413

Phone

(662) 512-0019

Fax

(662) 512-0430

NPI assigned

Aug 20, 2012

Last updated

Jan 9, 2014By 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 MS

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

Specialty

Optometry

Education

Southern College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ripley Eye Care, LLC

  • Optometrist
  • Ripley, MS
  • NPI 1841531977
  Medicare reassignment NPD Authorized official
• Feltz Vision Center Ms LLC

  • Optometrist
  • Madison, MS
  • NPI 1932682515
  Medicare reassignment NPD

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1336497510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 972",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386520972",
            "telephone_number": "662-512-0019",
            "fax_number": "662-534-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010B CITY AVE N",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631413",
            "telephone_number": "662-512-0019",
            "fax_number": "662-512-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JENNIFER",
        "middle_name": "STREET",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Campbell
• Dustin Cole Cantrell, PHARMD
• Sherri Carrigan
• Teena Cash, MS
• Patrick Stone Chapman, ED.D., L.P.C.
• Shelby Lane Cissom
• City Medical Supply, LLC
• Tabitha Leanne Clifton, RN
• Mary Cockrell, CCC-SLP
• Linda Cook

• Optometrist in Ripley, MS
• Providers in Ripley, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.