Active NPI
Jessica Maureen Neuville, O.D.
- Optometrist
- Glendale, AZ
National Provider Identifier
1720219009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1751
- Practice address
- 19555 N 59TH Ave
Glendale, AZ 85308-6813 - Phone
- (623) 572-3907
- NPI assigned
- Aug 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2009021551 | MO | |
| Optometrist | 152W00000X | 1751 | AZ | Primary |
Addresses
Primary practice location
19555 N 59TH Ave
Glendale, AZ 85308-6813
Mailing address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Phone (623) 572-3907
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1751 | AZ | MD | Optometrist |
| 2009021551 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1720219009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813",
"telephone_number": "623-572-3907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813",
"telephone_number": "623-572-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUVILLE",
"first_name": "JESSICA",
"middle_name": "MAUREEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-04",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2009021551",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.