Individual provider Active NPI

Jeffrey Scott Fleming, O.D.

  • Optometrist
  • Torrance, CA
National Provider Identifier
1679542989
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10049T Issued in CA
Practice address
4854 W 190TH St
Torrance, CA 90503-1002
Phone
(310) 371-1712
Fax
(310) 371-4674
NPI assigned
Mar 17, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10049T CA Primary
Corneal and Contact Management Optometrist 152WC0802X 10049T CA

Addresses

Primary practice location

4854 W 190TH St
Torrance, CA 90503-1002

Mailing address

4854 W 190TH St
Torrance, CA 90503-1002
Phone (310) 371-1712

Other identifiers 2

IdentifierTypeStateIssuer
1153670001OtherCACIGNA D-MERC #
4746525MedicaidCA

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
10049CAMDAddiction (Substance Use Disorder) Counselor
10049TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1679542989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4854 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031002",
            "telephone_number": "310-371-1712",
            "fax_number": "310-371-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4854 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031002",
            "telephone_number": "310-371-1712",
            "fax_number": "310-371-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10049T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "10049T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA D-MERC #",
            "identifier": "1153670001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4746525",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.