Jennifer Denhartog OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JENNIFER DENHARTOG OD LLC

Practice address

12695 University Ave Ste 170
Clive, IA 50325

Phone

(515) 512-1444

Fax

(515) 512-1440

NPI assigned

Apr 7, 2016

Last updated

Sep 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Denhartog, ODNPI 1285682245

Title

Owner/OD

Phone

(515) 512-1444

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Denhartog, O.D.

  • Optometrist
  • Clive, IA
  • NPI 1285682245
  Medicare reassignment Care Compare group NPD Authorized official
• Madilyn Fouse, OD

  • Optometrist
  • Memphis, TN
  • NPI 1538721782

  IA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1649634478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12695 UNIVERSITY AVE STE 170",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258217",
            "telephone_number": "515-512-1444",
            "fax_number": "515-512-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12695 UNIVERSITY AVE STE 170",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "50325",
            "telephone_number": "515-512-1444",
            "fax_number": "515-512-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Locust St",
            "address_2": "Suite 230",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "50309",
            "country_code": "US",
            "telephone_number": "515-281-0902",
            "fax_number": "515-281-0915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JENNIFER DENHARTOG OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "DENHARTOG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/OD",
        "authorized_official_telephone_number": "515-512-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1229344",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet L Jacobsen, RPH
• Carrie Janeczko, AUD
• Mary Louise Jankowski, LMHC, LMSW
• Erin M Jenkins, ARNP
• Jenna Schissel Therapy, LLC
• Brandi Jensen
• Samantha Dee Jensen, ARNP
• Korbyn R. Jerabek, PA-C
• Jacob Jipp, M.D.
• JMG Therapy and Counseling

• Optometrist in Clive, IA
• Providers in Clive, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.