Active NPI
Joshua Benjamin Jenkins, OD
- Optometrist
- Marietta,, OH
National Provider Identifier
1598736191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5316
- Practice address
- 307 Fourth Street
Marietta,, OH 45750-2002 - Phone
- (740) 373-3191
- Fax
- (740) 373-3196
- NPI assigned
- Jan 31, 2006
- 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 | 5316 | OH | Primary |
Addresses
Primary practice location
307 Fourth Street
Marietta,, OH 45750-2002
Mailing address
307 Fourth Street
Marietta,, OH 45750-2002
Phone (740) 373-3191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2347562 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3077 | TN | MD | Professional Counselor |
| 5316 | OH | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TN Doctors of Optometry, PLLC | Optometrist | Current | Accepting new patients |
| TN Doctors of Optometry, PLLC | Optometrist | Current | Accepting new patients |
| John a Bays OD & Assoc | Optometrist | Past | Accepting new patients |
Locations
1701 Gallatin Pike N
Madison, TN 37115
Phone (615) 868-2000
2012 Crossings Cir
Ste B
Spring Hill, TN 37174
Phone (931) 489-9151
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.
-
- Optometrist
- Collierville, TN
- NPI 1538827050
-
- Optometrist
- Marietta,, OH
- NPI 1225153554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266883200000",
"number": "1598736191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 FOURTH STREET",
"city": "MARIETTA,",
"state": "OH",
"postal_code": "457502002",
"telephone_number": "740-373-3191",
"fax_number": "740-373-3196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 FOURTH STREET",
"city": "MARIETTA,",
"state": "OH",
"postal_code": "457502002",
"telephone_number": "740-373-3191",
"fax_number": "740-373-3196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JOSHUA",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2010-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "5316",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2347562",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marietta,, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.