Active NPI
Richard Bruce Jensen, OD
- Optometrist
- Titusville, FL
National Provider Identifier
1356419550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC1228
- Practice address
- 414 Garden St
Titusville, FL 32796-2848 - Phone
- (321) 267-0231
- Fax
- (321) 267-0234
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | OPC1228 | FL | Primary |
Addresses
Primary practice location
414 Garden St
Titusville, FL 32796-2848
Mailing address
414 Garden St
Titusville, FL 32796-2848
Phone (321) 267-0231
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264809600000",
"number": "1356419550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962848",
"telephone_number": "321-267-0231",
"fax_number": "321-267-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962848",
"telephone_number": "321-267-0231",
"fax_number": "321-267-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "RICHARD",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2010-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC1228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.