Individual provider Active NPI

Jeffrey Blake Sperry, O.D.

  • Optometrist
  • Bozeman, MT
National Provider Identifier
1720040769
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7370PT Issued in MT
Practice address
2825 W Main St
#5D
Bozeman, MT 59718-3927
Phone
(406) 587-1212
Fax
(406) 586-8738
NPI assigned
Apr 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7370PT MT Primary

Addresses

Primary practice location

2825 W Main St
#5D
Bozeman, MT 59718-3927

Mailing address

1229 Barley Ave
Bozeman, MT 59718-6047
Phone (406) 585-1203

Other identifiers 1

IdentifierTypeStateIssuer
0482834MedicaidMT

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7370PTMTMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720040769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 BARLEY AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186047",
            "telephone_number": "406-585-1203",
            "fax_number": "406-586-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 W MAIN ST",
            "address_2": "#5D",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183927",
            "telephone_number": "406-587-1212",
            "fax_number": "406-586-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERRY",
        "first_name": "JEFFREY",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "7370PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0482834",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.