Active NPI
Jacob Heath, O.D.
- Optometrist
- Dexter, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2016023867
- Practice address
- 1207 N One Mile Rd
Dexter, MO 63841-1041 - Phone
- (573) 624-4584
- Fax
- (573) 624-4992
- NPI assigned
- Jul 21, 2016
- Last updated
- Apr 3, 2026
- Sex
- Male
- 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 | 2016023867 | MO | Primary |
Addresses
Primary practice location
1207 N One Mile Rd
Dexter, MO 63841-1041
Mailing address
1200 W Deyoung St
Marion, IL 62959-4437
Phone (618) 993-5686
Other practice location 1
117 N Main St
Charleston, MO 63834-1674
Phone (573) 683-2020
Other practice location 2
212 S Main St
Sikeston, MO 63801-3034
Phone (573) 572-8181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1207 N One Mile Rd
Dexter, MO 63841-1041
Phone (573) 624-4584
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016023867 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion Eye Centers LTD. | Optometrist | Current | Accepting new patients |
| Marion Eye Centers LTD. | Optometrist | Current | Accepting new patients |
Locations
1200 W Deyoung St
Marion, IL 62959
Phone 61899356861290
117 N Main St
Charleston, MO 63834
Phone (573) 683-2020
297 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 651-5200
1207 N One Mile Rd
Dexter, MO 63841
Phone (573) 624-4584
212 S Main St
Sikeston, MO 63801
Phone (573) 472-8181
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.
-
- Durable Medical Equipment & Medical Supplies
- Sparta, IL
- NPI 1982894465
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1558714840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W DEYOUNG ST",
"city": "MARION",
"state": "IL",
"postal_code": "629594437",
"telephone_number": "618-993-5686",
"fax_number": "618-997-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 N ONE MILE RD",
"city": "DEXTER",
"state": "MO",
"postal_code": "638411041",
"telephone_number": "573-624-4584",
"fax_number": "573-624-4992"
}
],
"practiceLocations": [
{
"address_1": "117 N Main St",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "MO",
"postal_code": "638341674",
"country_code": "US",
"telephone_number": "573-683-2020",
"fax_number": "573-683-4003",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "212 S Main St",
"address_purpose": "LOCATION",
"city": "Sikeston",
"state": "MO",
"postal_code": "638013034",
"country_code": "US",
"telephone_number": "573-572-8181",
"fax_number": "573-472-1700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEATH",
"first_name": "JACOB",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-21",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2016023867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dexter, MO
- Stacey A Grays, PMHNP
- Kristin Suzanne Wheeler Guethle, NP-C
- Harps Food Stores, Inc (Harps Pharmacy #212)
- Teddy C Hatfield, M.D.
- Health Services of Dexter, Inc
- Tracy Hedrick
- Hilda Fuwell's Residential Care LLC (Adaptive Services)
- Hilda Fuwells Residential Care (Adaptive Services)
- Hilda Fuwells Residential Care
- Hilda Fuwells Residential Care, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.