Individual provider Active NPI

Joshua Benjamin Jenkins, OD

  • Optometrist
  • Marietta,, OH
National Provider Identifier
1598736191
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5316 Issued in OH
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

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2347562MedicaidOH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141022001427 TN Practitioner - Optometry 7416900865 Reassigns benefits to 1 organization

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3077TNMDProfessional Counselor
5316OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
TN Doctors of Optometry, PLLC Optometrist CurrentSince Feb 6, 2023 Accepting new patients
TN Doctors of Optometry, PLLC Optometrist CurrentSince Feb 6, 2023 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.

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

Verify at the official NPI Registry.