Jack N Sperry Jr O.D. PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2330 Issued in FL

Legal business name

JACK N SPERRY JR O.D. PA

Practice address

720 Lake Dora Dr
Tavares, FL 32778-3314

Phone

(352) 551-5612

NPI assigned

Dec 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jack N Sperry Jr., O. D.

Title

President

Phone

(352) 551-5612

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1609145507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 LAKE DORA DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783314",
            "telephone_number": "352-551-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 LAKE DORA DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783314",
            "telephone_number": "352-551-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK N SPERRY JR O.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "SPERRY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-551-5612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078942900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "20357",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Tavares, FL
• Providers in Tavares, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.