NPIMap

Organization Active NPI

JD Optometrics, LLC

  • Clinic/Center
  • Ammon, ID
National Provider Identifier
1790027332
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ODP 100167 Issued in ID
Legal business name
JD OPTOMETRICS, LLC
Practice address
1201 S 25TH E
Ammon, ID 83406-5729
Phone
(208) 524-8978
NPI assigned
Mar 21, 2013
Last updated
Apr 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Authorized official

Name
Dr. Joshua G Davis, ODNPI 1548408891
Title
Optometrist/President
Phone
(208) 757-1227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ODP 100167 ID Primary

Addresses

Primary practice location

1201 S 25TH E
Ammon, ID 83406-5729

Mailing address

1201 S 25TH E
Ammon, ID 83406-5729
Phone (208) 524-8978

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1790027332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S 25TH E",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065729",
            "telephone_number": "208-524-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S 25TH E",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834065729",
            "telephone_number": "208-524-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD OPTOMETRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "208-757-1227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "ODP 100167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.