Organization Active NPI

J Brent Meek O D Inc

  • Optometrist
  • Paso Robles, CA
National Provider Identifier
1770654345
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
J BRENT MEEK O D INC
Practice address
1034 Vine St
Paso Robles, CA 93446-2528
Phone
(805) 238-4460
Fax
(805) 238-1715
NPI assigned
Nov 13, 2006
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Mr. Jerald Brent Meek, ODNPI 1003087693
Title
Owner
Phone
(805) 238-4460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

1034 Vine St
Paso Robles, CA 93446-2528

Mailing address

1034 Vine St
Paso Robles, CA 93446-2528
Phone (805) 238-4460

Other identifiers 1

IdentifierTypeStateIssuer
SD0088030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080411000391 CA Part B Supplier - Clinic/Group Practice 3779663935 Receives reassigned benefits from 2 practitioners
Practice locations: Paso Robles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1770654345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 VINE ST",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934462528",
            "telephone_number": "805-238-4460",
            "fax_number": "805-238-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 VINE ST",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934462528",
            "telephone_number": "805-238-4460",
            "fax_number": "805-238-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J BRENT MEEK O D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "MEEK",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-238-4460",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0088030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.