Jack David Adkins, O.D.
Individual provider Active NPI Optometrist · Lansing, MI
NPI 1487668562 · NPPES record last updated Jan 15, 2015
Key facts
- NPI
- 1487668562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901003058 (MI)
- Practice address
- 5020 W Saginaw Hwy
Lansing, MI 48917-2625 - Phone
- (517) 323-3399
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100907000575 | MI | Practitioner - Optometry | 4082738588 | Practice locations: Lansing, MI |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901003058 | MI | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003058 | MI | Yes |
Addresses
Primary practice location
5020 W Saginaw Hwy
Lansing, MI 48917-2625
Mailing address
5020 W Saginaw Hwy
Lansing, MI 48917-2625
Phone (517) 323-3399
Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.