Jerome WH Niswonger MD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JEROME WH NISWONGER MD INC

Doing business as

EYE LIFE INSTITUTE

Practice address

6283 Clark Rd
#10
Paradise, CA 95969-4100

Phone

(530) 877-2020

Fax

(530) 877-4641

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerome WH Niswonger, MD

Title

Owner/President

Phone

(530) 877-2020

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• EYE LIFE INSTITUTE Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Jeffery Gajda, M.D.

  • Ophthalmology Physician
  • Paradise, CA
  • NPI 1396839395
  NPD (past)
• Randall Ray McPherran, OD

  • Optometrist
  • Paradise, CA
  • NPI 1720001738
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1578584769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6283 CLARK RD",
            "address_2": "#10",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959694100",
            "telephone_number": "530-877-2020",
            "fax_number": "530-877-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6283 CLARK RD",
            "address_2": "#10",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959694100",
            "telephone_number": "530-877-2020",
            "fax_number": "530-877-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME WH NISWONGER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "NISWONGER",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "WH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "530-877-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZ22165Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ22165Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE LIFE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Robert Jacobsen, RPH
• Eileen Jakobsen
• Jessica Marie James
• Christopher Jensen, PA-C
• Donna Mae Jensen, LCSW
• Tami Deanne Jessen
• Jenifer Esther Jesson, DDS
• JJ&R Emergency Medical Group of California, Inc.
• Tiffany Nicole John
• Paula Judy Johnson, MFT

• Optometrist in Paradise, CA
• Providers in Paradise, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.