Jena Marie Jung, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA2155 Issued in MD

Practice address

45330 Abell House LN
California, MD 20619-3203

Phone

(301) 863-6080

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Grasee, Inc.

  dba Pearle Vision

  • Optometrist
  • California, MD
  • NPI 1386998987
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1871636472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45330 ABELL HOUSE LN",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193203",
            "telephone_number": "301-863-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45330 ABELL HOUSE LN",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193203",
            "telephone_number": "301-863-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JENA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2155",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND OPTOMETRY LICENSE",
            "identifier": "TA2155",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "301-863-6080",
            "affiliation": "N",
            "address_1": "45330 Abell House Ln",
            "city": "California",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206193203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Scott Tidball, MD, PC (Wildewood Medical Care)
• Anh Bui Johnsen
• Kiara Johnson
• Madisyn Jones
• Rebakah Amanda Jones, LMT, ICT, CST, MMP
• Katelyn Keesee
• William Presley Keeton III, PSY.D.
• Hailey Keils
• Taylor Kelly, CCC-SLP
• Kennedy Krieger Education and Community Services, Inc. (Kennedy Krieger School)

• Optometrist in California, MD
• Providers in California, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.