Kaitlin Griffith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010765 Issued in IL

Practice address

1689 W Morton Ave
Jacksonville, IL 62650-2717

Phone

(217) 245-8800

NPI assigned

May 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Kaitlin Alderman Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Illinois College of Optometry at Chicago, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J a K Enterprises IncGroup PAC ID 3173519014, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• J a K Enterprises Inc

  • Eyewear Supplier
  • Peoria, IL
  • NPI 1508856923
  Medicare reassignment Care Compare group
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, IL
  • NPI 1255617924

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Peoria, IL
  • NPI 1376581611

  Optometrist

  NPD (past)
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Moline, IL
  • NPI 1790723542

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1760894935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540",
            "fax_number": "309-693-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1689 W MORTON AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502717",
            "telephone_number": "217-245-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 W 1st Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625215207",
            "country_code": "US",
            "telephone_number": "217-422-3881",
            "fax_number": "217-422-3883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "KAITLIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01733864",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "ALDERMAN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Diane Green
• Mark Hindley Greene III, MD
• Jon Gregory, CRNA
• Cathy Grierson
• Anthony M Griffin, MD
• Guy Audet MD
• Rebbecca Ann Gwaltney, COTA/L
• Kyle Robert Hadden, MD
• Amy N. Haefeli, FNP-BC
• Marlee N Hager

• Optometrist in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.