Jea Optical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

JEA OPTICAL LLC

Practice address

1200 N State St Ste 110
Jackson, MS 39202-2027

Phone

(601) 352-0025

Fax

(601) 352-0037

NPI assigned

Jan 23, 2019

Organization subpart

No

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

Authorized official

Name

Robert Amory Mallette, MD

Title

Managing Partner

Phone

(601) 353-2020

Specialties & licenses 1

Addresses

Tax ID family

Jea Optical LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Jea Optical LLC

  • Durable Medical Equipment & Medical Supplies
  • Clinton, MS
  • NPI 1023572823
  NPD tax ID
• Jea Optical LLC

  • Durable Medical Equipment & Medical Supplies
  • Madison, MS
  • NPI 1215491014
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Glenn Herrington, M.D.

  • Ophthalmology Physician
  • Jackson, MS
  • NPI 1831194679
  NPD (past)

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1720542855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 330",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-353-2020",
            "fax_number": "601-352-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-352-0025",
            "fax_number": "601-352-0037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Clinton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390564730",
            "country_code": "US",
            "telephone_number": "601-924-9750",
            "fax_number": "601-925-9791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Baptist Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391102009",
            "country_code": "US",
            "telephone_number": "601-853-2020",
            "fax_number": "601-853-2728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEA OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "MALLETTE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "AMORY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "601-353-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arjun Jayaraj, MD
• Lance Tyler Jaynes, MD
• Robert Earl Jaynes, R.PH.
• Jberry, LPC, LLC
• Jcep,PLLC,
• Sheila Kalka Jeff, MD
• Gina Denise Jefferson, M.D.
• Kirk R. Jeffreys III, M.D.
• Lori Anne Jeffries
• Pamela Irene Jeffries, NP

• Durable Medical Equipment & Medical Supplies in Jackson, MS
• Providers in Jackson, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.