Individual provider Active NPI

Jennifer Zierlein, O.D.

  • Optometrist
  • Benton, AR
National Provider Identifier
1447538897
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2670 Issued in AR
Practice address
113 W Carpenter St
Benton, AR 72015-3317
Phone
(501) 778-2363
Fax
(501) 778-5329
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1891 KS
Optometrist 152W00000X 2011020453 MO
Optometrist 152W00000X 2670 AR Primary

Addresses

Primary practice location

113 W Carpenter St
Benton, AR 72015-3317

Mailing address

113 W Carpenter St
Benton, AR 72015-3317
Phone (501) 778-2363

Other identifiers 1

IdentifierTypeStateIssuer
195995722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20120823000269 AR Practitioner - Optometry 2163679382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simmons Eye Care Clinic, P.a.Group PAC ID 8628011384, 5 clinicians

Practice addresses (Care Compare)

113 W Carpenter St
Benton, AR 72015-3317
Phone (501) 778-2363

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1891KSMDOptometrist
2011020453MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Simmons Eye Care Clinic, P.a. Optometrist CurrentSince Aug 1, 2012 Accepting new patients
SS Eye Group, PLLC Optometrist PastSince Aug 1, 2012 Accepting new patients

Locations

113 W Carpenter St
Benton, AR 72015
Phone (501) 778-2363

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1447538897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W CARPENTER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153317",
            "telephone_number": "501-778-2363",
            "fax_number": "501-778-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W CARPENTER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153317",
            "telephone_number": "501-778-2363",
            "fax_number": "501-778-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIERLEIN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1891",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011020453",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195995722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.