Active NPI
Meredith Elaine Jansen, OD
- Optometrist
- Bloomington, IN
National Provider Identifier
1467682930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003585A
- Practice address
- 800 E Atwater Ave
Bloomington, IN 47405-3635 - Phone
- (812) 855-3986
- Fax
- (812) 855-5417
- NPI assigned
- Jul 20, 2009
- Last updated
- Jul 20, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003585A | IN | Primary |
Addresses
Primary practice location
800 E Atwater Ave
Bloomington, IN 47405-3635
Mailing address
1274 S College Mall Rd
Bloomington, IN 47401-6185
Phone (812) 454-1605
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University | Optometrist | Past | Accepting new patients |
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, 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": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248048000000",
"number": "1467682930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1274 S COLLEGE MALL RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474016185",
"telephone_number": "812-454-1605",
"fax_number": "812-855-5417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E ATWATER AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474053635",
"telephone_number": "812-855-3986",
"fax_number": "812-855-5417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "MEREDITH",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2009-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003585A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.