Individual provider Active NPI

Jason L Howard, O.D.

  • Optometrist
  • Emmett, ID
National Provider Identifier
1720436744
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100368 Issued in ID
Practice address
1108 S Washington Ave
Emmett, ID 83617-3535
Phone
(208) 365-2020
NPI assigned
May 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100368 ID Primary

Addresses

Primary practice location

1108 S Washington Ave
Emmett, ID 83617-3535

Mailing address

4969 S Valois Dr
Taylorsville, UT 84129-1678
Phone (801) 915-2109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20160815001085 ID Practitioner - Optometry 7911291992 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100368IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emmett Eye Center, PLLC Optometrist CurrentSince Aug 1, 2016 Accepting new patients
Dallas Stevens OD PA Optometrist Current Accepting new patients

Locations

1108 S Washington Ave
Emmett, ID 83617
Phone (208) 365-2020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1720436744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 S VALOIS DR",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291678",
            "telephone_number": "801-915-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173535",
            "telephone_number": "208-365-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "JASON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmett, ID

Sources for this page

Verify at the official NPI Registry.