Organization Active NPI

Jane Compton OD LLC

  • Optometrist
  • Taos, NM
National Provider Identifier
1659940690
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JANE COMPTON OD LLC
Practice address
710 Paseo del Pueblo Sur Ste F
Taos, NM 87571-6062
Phone
(575) 758-2205
Fax
(575) 751-7102
NPI assigned
Jun 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Louise Fernandez, OD
Title
Owner
Phone
(575) 758-2205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

710 Paseo del Pueblo Sur Ste F
Taos, NM 87571-6062

Mailing address

PO Box 1867
Taos, NM 87571-1867
Phone (575) 758-2205

Other identifiers 1

IdentifierTypeStateIssuer
P0771MedicaidNM

Other names 1

  • Jane Compton OD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210727003074 NM Part B Supplier - Clinic/Group Practice 4082017173 Receives reassigned benefits from 1 practitioner
Practice locations: Taos, NM

National Provider Directory

National Provider Directory

Locations

710 S Santa Fe Rd
Ste F
Taos, NM 87571
Phone (505) 758-2205

Practitioners & affiliated clinicians

Practitioners 2

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": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1659940690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1867",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875711867",
            "telephone_number": "575-758-2205",
            "fax_number": "575-751-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PASEO DEL PUEBLO SUR STE F",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716062",
            "telephone_number": "575-758-2205",
            "fax_number": "575-751-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE COMPTON OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-758-2205",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P0771",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jane Compton OD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jane Compton OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.