Individual provider Active NPI

Jenna Nieman, O.D.

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1629428511
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
006731 Issued in OH
Practice address
7800 Montgomery Rd Unit 5
Cincinnati, OH 45236-4306
Phone
(513) 793-5970
Fax
(513) 793-5976
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3348 TN
Optometrist 152W00000X 0618002513 VA
Optometrist 152W00000X 006731 OH Primary

Addresses

Primary practice location

7800 Montgomery Rd Unit 5
Cincinnati, OH 45236-4306

Mailing address

2011 N Roan St
Space E-6
Johnson City, TN 37601-3130
Phone (423) 610-7155

Other practice location 1

7630 Blake St
Liberty Township, OH 45069-7520
Phone (513) 712-5065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190906000657 OH Practitioner - Optometry 8729361506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Tonya D. Lindsell and Associates, LLCGroup PAC ID 2163433640, 12 clinicians

Practice addresses (Care Compare)

7800 Montgomery Rd
Unit 5
Cincinnati, OH 45236-4306
Phone (513) 793-5970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006731OHMDOptometrist
0618002513VAMDOptometrist
3348TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tonya D. Lindsell and Associates, LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

7800 Montgomery Rd
Unit 5
Cincinnati, OH 45236
Phone (513) 793-5970

4601 Eastgate Blvd
#C578
Cincinnati, OH 45245
Phone (513) 232-2230

7630 Blake St
Liberty Township, OH 45069
Phone (513) 712-5064

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1629428511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 N ROAN ST",
            "address_2": "SPACE E-6",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013130",
            "telephone_number": "423-610-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 MONTGOMERY RD UNIT 5",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364306",
            "telephone_number": "513-793-5970",
            "fax_number": "513-793-5976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7630 Blake St",
            "address_purpose": "LOCATION",
            "city": "Liberty Township",
            "state": "OH",
            "postal_code": "450697520",
            "country_code": "US",
            "telephone_number": "513-712-5065",
            "fax_number": "513-755-1741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMAN",
        "first_name": "JENNA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3348",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002513",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "006731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.