Individual provider Active NPI

Heather M. Jetton, O.D.

  • Optometrist
  • Richmond, VA
National Provider Identifier
1699742684
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002640 Issued in VA
Practice address
400 Westhampton Sta
Richmond, VA 23226-3330
Phone
(804) 287-4200
Fax
(804) 287-4210
NPI assigned
Mar 8, 2006
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4543 MA
Optometrist 152W00000X 8163077-9934 UT
Optometrist 152W00000X 0300000348 VT
Optometrist 152W00000X 0618002640 VA Primary

Addresses

Primary practice location

400 Westhampton Sta
Richmond, VA 23226-3330

Mailing address

400 Westhampton Sta
Richmond, VA 23226-3330
Phone (804) 287-4200

Other identifiers 5

IdentifierTypeStateIssuer
0704598MedicaidMA
AA46054OtherMAHARVARD PILGRIM HEALTHCAR
36991OtherMAHEALTH NEW ENGLAND
W16443OtherMABLUE CROSS BLUE SHIELD OF
454300OtherMACONNECTICARE, INC.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20180604000469 VA Practitioner - Optometry 8921063199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Visioncare PLLCGroup PAC ID 7911122809, 2 clinicians

Practice addresses (Care Compare)

204 Johnson Creek Dr
Chester, VA 23836-2840
Phone (804) 530-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8163077-9934UTMDOptometrist
0618002640VAMDOptometrist
0300000348VTMDOptometrist
4543MAMDSpeech-Language Pathologist
0764NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Visioncare, PLLC Optometrist CurrentSince Feb 14, 2024 Accepting new patients
Eye Care Associates, PC PastSince Jan 1, 2007 Accepting new patients
Dr. Dorothy L. Hitchmoth, PLLC Optometrist PastSince Jan 26, 2022 Accepting new patients

Locations

204 Johnson Creek Dr
Chester, VA 23836
Phone (804) 530-3937

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1699742684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTON",
        "first_name": "HEATHER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4543",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "8163077-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "0300000348",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0704598",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA46054",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "36991",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "W16443",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE, INC.",
            "identifier": "454300",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.