Individual provider Active NPI

Jennifer A Overton, OD

  • Optometrist
  • West Des Moines, IA
National Provider Identifier
1578537007
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02233 Issued in IA
Practice address
1540 Valley West Dr
West Des Moines, IA 50266-1101
Phone
(515) 223-8666
Fax
(515) 225-1411
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02233 IA Primary

Addresses

Primary practice location

1540 Valley West Dr
West Des Moines, IA 50266-1101

Mailing address

3725 Ingersoll Ave
Des Moines, IA 50312-3410
Phone (515) 279-2020

Other identifiers 2

IdentifierTypeStateIssuer
31302OtherIABLUE CROSS
0274886MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20100813000964 IA Practitioner - Optometry 7113051038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02233IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
CVK Corporation CurrentSince Aug 1, 2010 Accepting new patients
CVK Corporation Optometrist CurrentSince Aug 1, 2010 Accepting new patients
Eyemart Express LLC PastSince Apr 13, 2025 Accepting new patients

Locations

3725 Ingersoll Ave
Des Moines, IA 50312
Phone (515) 255-5533

1540 Valley West Dr
West Des Moines, IA 50266
Phone (515) 223-8666

Organizations & group practices 3

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1578537007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123410",
            "telephone_number": "515-279-2020",
            "fax_number": "515-255-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 VALLEY WEST DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661101",
            "telephone_number": "515-223-8666",
            "fax_number": "515-225-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "02233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "31302",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0274886",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.