Jon Bantugan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1129 Issued in MS

Practice address

2011 Highway 61 N
Vicksburg, MS 39183-8227

Phone

(601) 630-9199

Fax

(601) 630-0426

NPI assigned

Jul 14, 2026

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Specialty

Optometry

Education

Southern College of Optometry, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24012/brand/1/csg/1/fhir/r4

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.

• Riverbend Eyecare, P.a.

  • Optometrist
  • Vicksburg, MS
  • NPI 1811957624
  NPD
• Riverbend Healthcare PLLC

  • Clinic/Center
  • Vicksburg, MS
  • NPI 1417620071
  NPD

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

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1346169299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838227",
            "telephone_number": "601-630-9199",
            "fax_number": "601-630-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838227",
            "telephone_number": "601-630-9199",
            "fax_number": "601-630-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTUGAN",
        "first_name": "JON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Cox Ballard, M.S. CCC-SLP
• Paul Edward Ballard, DMD
• Jan Banks, CMHT
• Mechael M Banks
• Michelle Banks, NP
• Tiffany Banyard, SLP
• Madalene J Barksdale-Mayfield
• Constance Phylea Barnes-Woods, M.D.
• John R Barnes, MD
• Susan Barnett

• All providers in Vicksburg, MS
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.