Jessica Laffoon

Primary specialty

OptometristTaxonomy code 152W00000X

License

2014016610 Issued in MO

Practice address

12681 Dorsett Rd
Maryland Heights, MO 63043-2100

Phone

(314) 786-3800

Fax

(314) 786-3801

NPI assigned

Jul 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Olendorff Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarkson Optometry IncGroup PAC ID 0840411799, 82 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessicaolendorff@direct.eyecare-partners.com

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.

• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Inc

  • Optometrist
  • Elk River, MN
  • NPI 1952992976
  NPD
• Clarkson Eyecare

  • Optometrist
  • Eureka, MO
  • NPI 1205817731
  NPD (past)

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1679980858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207158",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207158",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12681 DORSETT RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432100",
            "telephone_number": "314-786-3800",
            "fax_number": "314-786-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFOON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2014016610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "OLENDORFF",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Malcolm Koldin, M.D.
• Donald Scott Kreidler, D.C.
• Daniel J Krolak
• Catherine Ann Kush, DNP, GNP-BC
• Gianna Rose Labriola
• Theodore Langham
• Charles S Larsen, D.O.
• Tiara Isis Lashley
• Brittany Elizabeth Lazear
• Jennifer Ann Leary, PNP

• Optometrist in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.