Jewell R. Chang OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2950 Issued in FL

Legal business name

JEWELL R. CHANG OD PA

Practice address

3201 NE Skyline Dr
Suite D
Jensen Beach, FL 34957-3912

Phone

(772) 334-4264

Fax

(772) 334-4265

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jewell Renee Chang, ODNPI 1407830730

Title

President

Phone

(772) 334-4264

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jewell Renee Chang, OD

  • Optometrist
  • Jensen Beach, FL
  • NPI 1407830730
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1841314945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 NE SKYLINE DR",
            "address_2": "SUITE D",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573912",
            "telephone_number": "772-334-4264",
            "fax_number": "772-334-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 NE SKYLINE DR",
            "address_2": "SUITE D",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573912",
            "telephone_number": "772-334-4264",
            "fax_number": "772-334-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWELL R. CHANG OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JEWELL",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-334-4264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "20621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5624127",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steffie Michelle Jean-Baskin, MSW
• Jensen Beach Animal Hospital , LLC
• Jensen Beach Dental Center
• Jensen Beach Family Practice, Inc
• Jensen Physical Therapy Inc.
• Melinda Johnson, LCSW
• Allison Kaellen Jones, MOTR/L, DPT
• Virginia O Jones, LCSW
• Lynn Anne Jordan, LCSW
• Vanessa Joseph, RPH

• Optometrist in Jensen Beach, FL
• Providers in Jensen Beach, FL by specialty
• Optometrist in Florida

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