Chantal H Jacques, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002953 Issued in VA

Practice address

14337 Newbrook Dr Ste 400
Chantilly, VA 20151-4259

Phone

(571) 512-5990

Fax

(571) 512-5989

NPI assigned

Jul 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, DC, VA, FL4 enrollments

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 4

Specialty

Optometry

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Virginia PLLC

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment NPD
• Friendly Eyes Optometry LLC

  • Clinic/Center
  • Pompano Beach, FL
  • NPI 1811708977
  Medicare reassignment NPD
• University of Pikeville

  • Optometrist
  • Pikeville, KY
  • NPI 1841657947
  Medicare reassignment NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Yorktown, VA
  • NPI 1710533963
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD
• Visual Health Doctors of Optometry

  • Corneal and Contact Management Optometrist
  • Arlington, VA
  • NPI 1265974000
  NPD (past)
• America'S Best Contacts & Eyeglasses

  • Optician
  • Saint Louis, MO
  • NPI 1225069396
  NPD (past)
• Illini Optometric PC

  • Optometrist
  • Godfrey, IL
  • NPI 1780850032
  NPD (past)
• Rose Optical, Inc.

  • Optometrist
  • Godfrey, IL
  • NPI 1669444063
  NPD (past)

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1801025960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14337 NEWBROOK DR STE 400",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514259",
            "telephone_number": "571-512-5990",
            "fax_number": "571-512-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "CHANTAL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2009016926",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010234",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dixine D Iverson, COTA
• Lisa Jackson-Wardlaw, LCSW
• Catherine Elizabeth Jackson
• Hope Lachiel Jackson
• Ileana Jackson, OT
• Sydney Mae Jakubik
• Maria Jaramillo
• Jason Farr Favagehi DDS III PC
• Afton M Jaster
• Lizzy Beatrice Javier, PT

• Optometrist in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.