Active NPI
Jessica Lam
- Optometrist
- Memphis, TN
National Provider Identifier
1699138222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3395
- Practice address
- 930 Madison Ave Ste 200
Memphis, TN 38103-3452 - Phone
- (901) 448-6650
- NPI assigned
- Mar 31, 2016
- Sex
- Female
- 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 | 3395 | TN | Primary |
Addresses
Primary practice location
930 Madison Ave Ste 200
Memphis, TN 38103-3452
Mailing address
1407 Union Ave Ste 700
Memphis, TN 38104-3641
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01788595 | Medicaid | MS | |
| 1699138222 | Medicaid | MO | |
| Q031054 | Medicaid | TN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1699138222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 UNION AVE STE 700",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381043641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 MADISON AVE STE 200",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381033452",
"telephone_number": "901-448-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-31",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "3395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01788595",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1699138222",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q031054",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.