Individual provider Active NPI

Jennifer Jabaley, O.D.

  • Optometrist
  • Cartersville, GA
National Provider Identifier
1407949092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1774 Issued in GA
Practice address
837 Joe Frank Harris Parkway
Cartersville, GA 30120
Phone
(770) 382-2020
Fax
(770) 382-4880
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1774 GA Primary

Addresses

Primary practice location

837 Joe Frank Harris Parkway
Cartersville, GA 30120

Mailing address

837 Joe Frank Harris Parkway
Cartersville, GA 30120
Phone (770) 382-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000596 GA Practitioner - Optometry 7012157035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jabaley Vision AssociatesGroup PAC ID 2365477817, 2 clinicians

Practice addresses (Care Compare)

1333 Damascus Cir
Blue Ridge, GA 30513-6152
Phone (706) 946-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1774GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Eyecare, PC Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407949092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 JOE FRANK HARRIS PARKWAY",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-382-2020",
            "fax_number": "770-382-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 JOE FRANK HARRIS PARKWAY",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-382-2020",
            "fax_number": "770-382-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABALEY",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.