Individual provider Active NPI

Jason M Jennings, CPO, LPO

  • Prosthetist
  • Friendswood, TX
National Provider Identifier
1366700445
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
1308 Issued in TX
Practice address
106 Pecan Dr
Friendswood, TX 77546-3828
Phone
(713) 397-9558
NPI assigned
Apr 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X 1308 TX Primary
Orthotist 222Z00000X 1308 TX

Addresses

Primary practice location

106 Pecan Dr
Friendswood, TX 77546-3828

Mailing address

106 Pecan Dr
Friendswood, TX 77546-3828
Phone (713) 397-9558

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1308TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lazy J Bar D, LLC Orthotist Current Accepting new patients
Axis Orthotics and Prosthetics LLC Orthotist Past Accepting new patients
Axis Orthotics and Prosthetics LLC Prosthetist Past Accepting new patients

Locations

106 Pecan Dr
Friendswood, TX 77546
Phone (281) 996-6888

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1366700445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 PECAN DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463828",
            "telephone_number": "713-397-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PECAN DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463828",
            "telephone_number": "713-397-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "CPO, LPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "TX",
            "license": "1308",
            "primary": true
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "TX",
            "license": "1308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.