Organization Active NPI

Jicha Eye Care and Associates PLLC

  • Optometrist
  • High Point, NC
National Provider Identifier
1366420770
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JICHA EYE CARE AND ASSOCIATES PLLC
Practice address
3911 Fountain Grove Drive
Suite 101
High Point, NC 27265-8332
Phone
(336) 889-2225
Fax
(336) 889-2252
NPI assigned
Jan 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
Dr. Dianna Popa Jicha, OD
Title
Owner
Phone
(336) 889-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3911 Fountain Grove Drive
Suite 101
High Point, NC 27265-8332

Mailing address

3911 Fountain Grove Dr
Suite 101
High Point, NC 27265-8032
Phone (336) 889-2225

Other identifiers 1

IdentifierTypeStateIssuer
89015MCMedicaidNC

National Provider Directory

National Provider Directory

Locations

3911 Fountain Grove Dr
Ste 101
High Point, NC 27265
Phone (336) 889-2225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1366420770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 FOUNTAIN GROVE DR",
            "address_2": "SUITE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658032",
            "telephone_number": "336-889-2225",
            "fax_number": "336-889-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 FOUNTAIN GROVE DRIVE",
            "address_2": "SUITE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658332",
            "telephone_number": "336-889-2225",
            "fax_number": "336-889-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JICHA EYE CARE AND ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "JICHA",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_middle_name": "POPA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-889-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015MC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.