Julia Rebecca Meyer Jackson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2609 Issued in AR

Practice address

723 S. Falls Blvd
Ste a
Wynne, AR 72396-0562

Phone

(870) 238-2020

NPI assigned

Jul 24, 2008

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childers and Jackson Family Eye Care IncGroup PAC ID 0749478949, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Childers and Jackson Family Eye Care Inc.

  • Optometrist
  • Wynne, AR
  • NPI 1003125535
  Medicare reassignment Care Compare group NPD Authorized official
• Kerry Childers, O.D., P.a.

  • Corneal and Contact Management Optometrist
  • Wynne, AR
  • NPI 1568597409
  NPD

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1568627958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 S. FALLS BLVD",
            "address_2": "STE A",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960562",
            "telephone_number": "870-238-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 S. FALLS BLVD",
            "address_2": "STE A",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960562",
            "telephone_number": "870-238-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIA",
        "middle_name": "REBECCA MEYER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2609",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AR",
            "license": "2609",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "AR",
            "license": "2609",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "AR",
            "license": "2609",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AR",
            "license": "2609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "4T021",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6477243001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175315722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hughes Life Counseling, LLC
• Thomas Clayton Hughes, LPC
• Kimberly Dawn Hunt-Thornhill
• Elizabeth Hylle
• Amy E. Jackson, PT, DPT
• Neall Clark Jackson, D.D.S.
• Jacob Sutton, DDS, PA (Sutton Puryear Family Dentistry)
• James R Jacobs, M.D.
• Jherica James
• Alexandria Gaines Jarrett, MCD, CF-SLP

• Optometrist in Wynne, AR
• Providers in Wynne, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.

Verify at the official NPI Registry.