Jessica Lauren Unruh, O.D.
Individual provider Active NPI Optometrist · Hesston, KS
NPI 1770896367 · NPPES record last updated Feb 22, 2022
Key facts
- NPI
- 1770896367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1884 (KS)
- Practice address
- 607 E Randall St
Hesston, KS 67062-8814 - Phone
- (620) 327-2800
- Fax
- (620) 327-2055
- NPI assigned
- Jul 23, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100913000030 | KS | Practitioner - Optometry | 5698890812 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10341 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 1884 | KS | MD | Optometrist |
Interoperability endpoints
- junruh933410@direct.sw.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1884 | KS | Yes |
Addresses
Primary practice location
607 E Randall St
Hesston, KS 67062-8814
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Other practice location 1
1815 S 31st St
Temple, TX 76504-6728
Phone (254) 724-2111
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | junruh933410@direct.sw.org |
Other providers in Hesston, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.