Shane Jones, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

007060 Issued in OH

Practice address

399 E Church St Ste 101
Marion, OH 43302-4143

Phone

(740) 387-8414

Fax

(740) 382-9434

NPI assigned

May 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Optometry Group, LLCGroup PAC ID 6901806306, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Premier Optometry Group, LLC

  • Optometrist
  • Marion, OH
  • NPI 1770667057
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1700524980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E CHURCH ST STE 101",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433024143",
            "telephone_number": "740-387-8414",
            "fax_number": "740-382-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E CHURCH ST STE 101",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433024143",
            "telephone_number": "740-387-8414",
            "fax_number": "740-382-9434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 S Poplar St",
            "address_purpose": "LOCATION",
            "city": "Bucyrus",
            "state": "OH",
            "postal_code": "448202663",
            "country_code": "US",
            "telephone_number": "419-562-3822",
            "fax_number": "419-562-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "007060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eyecare@premieroptometry.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Adress",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "399 E Church St Ste 101",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433024143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacy E Jolley I
• Amirah Christine Jones
• Brittany Jones
• Chelsey Jones
• Jessica Jones
• Kathrine M Jordan, STNA
• Samantha M Jordan
• Patty A Joseph
• Satish S Joshi, MD
• Journey Home Health & Hospice , LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.