Active NPI
Jon L Woods, O.D.
- Optometrist
- Fairview Heights, IL
National Provider Identifier
1669509576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 46-6501
- Practice address
- 10900 Lincoln TRL
Fairview Heights, IL 62208-2042 - Phone
- (618) 398-5005
- NPI assigned
- Feb 27, 2007
- 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 | 46-6501 | IL | Primary |
Addresses
Primary practice location
10900 Lincoln TRL
Fairview Heights, IL 62208-2042
Mailing address
10900 Lincoln TRL
Fairview Heights, IL 62208-2042
Phone (618) 398-5005
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 |
|---|---|---|---|
| 46-6501 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JFJ Eyecare LTD | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669509576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10900 LINCOLN TRL",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622082042",
"telephone_number": "618-398-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10900 LINCOLN TRL",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622082042",
"telephone_number": "618-398-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "JON",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "46-6501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairview Heights, IL
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.