Individual provider Active NPI

Jon Sills, O.D.

  • Optometrist
  • Ventura, CA
National Provider Identifier
1467593186
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6804 Issued in CA
Practice address
4601 Telephone Rd Ste 109
Ventura, CA 93003-5671
Phone
(805) 642-4185
Fax
(805) 642-4416
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6804 CA Primary

Addresses

Primary practice location

4601 Telephone Rd Ste 109
Ventura, CA 93003-5671

Mailing address

4601 Telephone Rd Ste 109
Ventura, CA 93003-5671
Phone (805) 642-4185

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6804CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Strickland Optometric Corporation Optometrist CurrentSince Feb 1, 2016 Accepting new patients

Locations

4601 Telephone Rd
Ste 109
Ventura, CA 93003
Phone (805) 642-4185

Organizations & group practices 1

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1467593186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 TELEPHONE RD STE 109",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035671",
            "telephone_number": "805-642-4185",
            "fax_number": "805-647-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 TELEPHONE RD STE 109",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035671",
            "telephone_number": "805-642-4185",
            "fax_number": "805-642-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLS",
        "first_name": "JON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.