NPIMap

Organization Active NPI

Jillian Iris Okeefe OD PA

  • Optometrist
  • Greensboro, NC
National Provider Identifier
1629636402
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JILLIAN IRIS OKEEFE OD PA
Practice address
226 S Elm St
Greensboro, NC 27401-2692
Phone
(336) 333-2993
NPI assigned
Jun 5, 2019
Organization subpart
Yes
Parent organization
WINSTON SALEM OPTOMETRICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Jillian Iris Okeefe, ODNPI 1821153230
Title
Owner/Optometrist
Phone
(336) 722-5346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

226 S Elm St
Greensboro, NC 27401-2692

Mailing address

226 S Elm St
Greensboro, NC 27401-2692
Phone (336) 333-2993

Other identifiers 1

IdentifierTypeStateIssuer
1821153230OtherNCNPI

Other names 1

  • Oscar Oglethorpe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201001001961 NC Part B Supplier - Clinic/Group Practice 2365861804 Receives reassigned benefits from 3 practitioners
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory
Part of
Jillian Iris Okeefe OD PA

Locations

226 S Elm St
Ste A
Greensboro, NC 27401
Phone (336) 333-2993

302 S Stratford Rd
Ste B
Winston Salem, NC 27103
Phone (336) 333-2993

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1629636402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012692",
            "telephone_number": "336-333-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012692",
            "telephone_number": "336-333-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILLIAN IRIS OKEEFE OD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINSTON SALEM OPTOMETRIC",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "OKEEFE",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "IRIS",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "336-722-5346",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821153230",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oscar Oglethorpe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.