Individual provider Active NPI

Anastasia Camille Jobson, O. D.

  • Optometrist
  • Lauderdale Lakes, FL
National Provider Identifier
1659446268
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3904 Issued in FL
Practice address
3001 N. State Road #7
Lauderdale Lakes, FL 33313
Phone
(954) 497-0846
NPI assigned
Nov 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3904 FL Primary

Addresses

Primary practice location

3001 N. State Road #7
Lauderdale Lakes, FL 33313

Mailing address

2961 NE 185TH St
#1601
Aventura, FL 33180-2938
Phone (305) 935-5067

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

LicenseStateTypeSpecialty
OPC 3904FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlene Cruz-Govin O D PA Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659446268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 NE 185TH ST",
            "address_2": "#1601",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802938",
            "telephone_number": "305-935-5067",
            "fax_number": "954-733-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 N. STATE ROAD #7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "33313",
            "telephone_number": "954-497-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBSON",
        "first_name": "ANASTASIA",
        "middle_name": "CAMILLE",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.