Jenna Jeffries, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6288 T3204 Issued in OH

Practice address

3200 Atlantic Blvd NE
Canton, OH 44705-3933

Phone

(330) 489-9145

NPI assigned

Jun 23, 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

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jenna M Jeffries OD LLC

  • Optometrist
  • Canton, OH
  • NPI 1922777135
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1679988216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5274 WOODVIEW AVE",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446418835",
            "telephone_number": "330-323-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 ATLANTIC BLVD NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447053933",
            "telephone_number": "330-489-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "JENNA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6288 T3204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Michelle Jay-Bradley, BSN, RN, MSN, FNP-C
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• Jean Claude Tabet
• Brandon Jeffers, PSS
• Mackenzie Jeffers
• Victoria Ann Jenei
• Chelsea Jenkins, LPN
• Christine M Jenkins
• Damarco Kijier Jenkins
• Darnella L Jenkins

• Optometrist in Canton, OH
• Providers in Canton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.