Active NPI
Eyecenter PA
Doing business as Jerome Eyecenter
- Optometrist
- Jerome, ID
National Provider Identifier
1699862805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- EYECENTER PA
- Doing business as
- Jerome Eyecenter
- Practice address
- 201 South Lincoln
Jerome, ID 83338-2624 - Phone
- (208) 324-4363
- Fax
- (208) 324-8948
- NPI assigned
- Oct 7, 2006
- Last updated
- Jan 8, 2008
- Organization subpart
- Yes
- Parent organization
- EYECENTER PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James A Davis, OD
- Title
- Owner Optometrist
- Phone
- (208) 324-4363
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
201 South Lincoln
Jerome, ID 83338-2624
Mailing address
201 South Lincoln
Jerome, ID 83338-2624
Phone (208) 324-4363
Other names 1
- Jerome Eyecenter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051107001076 | ID | Part B Supplier - Clinic/Group Practice | 4486672565 |
Receives reassigned benefits from 5 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ketchum, ID; Twin Falls, ID; Jerome, ID; Hailey, ID |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Eyecenter PA
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Jerome, ID
- NPI 1164533485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160179200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199750400000",
"number": "1699862805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 SOUTH LINCOLN",
"city": "JEROME",
"state": "ID",
"postal_code": "833382624",
"telephone_number": "208-324-4363",
"fax_number": "208-324-8948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 SOUTH LINCOLN",
"city": "JEROME",
"state": "ID",
"postal_code": "833382624",
"telephone_number": "208-324-4363",
"fax_number": "208-324-8948"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYECENTER PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EYECENTER PA",
"enumeration_date": "2006-10-07",
"last_updated": "2008-01-08",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER OPTOMETRIST",
"authorized_official_telephone_number": "208-324-4363",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jerome Eyecenter",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jerome, ID
- Newell Tyler Elison, DDS
- Tammy Emerson, MS CCC SLP
- Curtis Phillip Emery, RT (R)(CT)
- David J Erickson, DO
- Kyana Evalyn
- Family Care Physicians, PA
- Family Health Services Corporation
- Family Health Services Corporation (Family Health Services)
- Family Health Services Corporation
- Family Health Services Corporation (Family Health Services - Diabetic Education)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.