Active NPI
Jeffrey W Klink, O.D.
- Optometrist
- Sacramento, CA
National Provider Identifier
1639174378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6847T
- Practice address
- 1689 Arden Way
#1344
Sacramento, CA 95815-4030 - Phone
- (916) 922-1977
- Fax
- (916) 922-4373
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 6847T | CA | Primary |
Addresses
Primary practice location
1689 Arden Way
#1344
Sacramento, CA 95815-4030
Mailing address
1689 Arden Way
#1344
Sacramento, CA 95815-4030
Phone (916) 922-1977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0068470 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6847 | CA | MD | Counselor |
| 6847T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1639174378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1689 ARDEN WAY",
"address_2": "#1344",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154030",
"telephone_number": "916-922-1977",
"fax_number": "916-922-4373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1689 ARDEN WAY",
"address_2": "#1344",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154030",
"telephone_number": "916-922-1977",
"fax_number": "916-922-4373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINK",
"first_name": "JEFFREY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6847T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0068470",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.