Christopher Jacob, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10901488-9934 Issued in UT

Practice address

262 E 400 S
Springville, UT 84663-1956

Phone

(801) 489-5166

NPI assigned

Jun 16, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Pacific University - College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Vision Services LLCGroup PAC ID 8820256001, 9 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Senior Vision Services LLC

  • Optometrist
  • Omaha, NE
  • NPI 1861779266

  UT

  Medicare reassignment Care Compare group NPD
• CLR Vision PC

  • Optometrist
  • Provo, UT
  • NPI 1235304064
  Medicare reassignment NPD
• CLR Vision PC

  • Optometrist
  • Springville, UT
  • NPI 1396926002
  NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  NPD (past)

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1336520386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1584 E 350 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 E 400 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846631956",
            "telephone_number": "801-489-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3609ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "10901488-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Paul Jackson, PH.D.
• Edward William Jackson, MD
• Jonathan D Jackson, D.D.S.
• London Teri Jackson, FNP-C
• Michael Robert Jackson, CSW
• Allessandra Corine Jacobsen, LAMFT
• Kevin Jacobsen
• Pamela Jamison, M.E/CCC-SLP
• Jared C. Condie DMD & Brian L. Tuft DMD LLC
• Christine Jeffs, RDH

• Optometrist in Springville, UT
• Providers in Springville, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.