Jerome WH Niswonger MD Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

JEROME WH NISWONGER MD INC

Doing business as

Eye Life Institute

Practice address

111 Raley Blvd
#240
Chico, CA 95928-8351

Phone

(530) 892-2020

Fax

(530) 898-9614

NPI assigned

Jul 22, 2006

Last updated

Oct 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerome WH Niswonger, MD

Title

Owner/President

Phone

(530) 877-2020

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EYE LIFE INSTITUTE Doing business as

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1457372658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 CLARK RD",
            "address_2": "#10",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959694100",
            "telephone_number": "530-877-2020",
            "fax_number": "530-877-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RALEY BLVD",
            "address_2": "#240",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288351",
            "telephone_number": "530-892-2020",
            "fax_number": "530-898-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME WH NISWONGER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "NISWONGER",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "WH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "530-877-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ41345Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ41345Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE LIFE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Jennings, LCSW
• Marilynn Lee Jennings, LMFT
• Nancy Ann Jennings, BSN RN PHN
• Lois A Jensen, M.D.
• Yeaeun Jeong
• Steven Jerome
• Jesus Provides Our Daily Bread (Jesus Center)
• Christina Lynn Jewell
• Tony C Jewett, DDS
• Ramandip Kaur Jhajj

• Ophthalmology Physician in Chico, CA
• Providers in Chico, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.