Jones Optical Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008644 Issued in IL

Legal business name

JONES OPTICAL INC

Practice address

1711 S Neil St
Champaign, IL 61820-7298

Phone

(217) 359-2390

Fax

(217) 359-3180

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Erik Duane Burgwald, O.D.NPI 1689644684

Title

President Owner

Phone

(217) 359-2390

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Erik Duane Burgwald, OD

  • Optometrist
  • Champaign, IL
  • NPI 1689644684
  Medicare reassignment Care Compare group Authorized official
• Kelly Alice Sanders, OD

  • Optometrist
  • Urbana, IL
  • NPI 1619013117
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1376672998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207298",
            "telephone_number": "217-359-2390",
            "fax_number": "217-359-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207298",
            "telephone_number": "217-359-2390",
            "fax_number": "217-359-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BURGWALD",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "217-359-2390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1689644684",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Johnson, SLP
• Sarah Johnson
• Tieona Johnson
• Traveon Johnson
• Robert B Johnston, M.D.
• Amy Kristine Jones, M.S.
• Anthony Thomas Jones, MSW
• Candy Jones, CCP
• Chioma Jones
• Cory Jones

• Optometrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.