JTD MD PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

JTD MD PLLC

Practice address

1794 E Joyce Blvd Ste 3
Fayetteville, AR 72703-5257

Phone

(479) 234-4499

Fax

(479) 269-1325

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Rick Kamerer

Title

Administrator

Phone

(479) 408-4466

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1881285187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1794 E JOYCE BLVD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035257",
            "telephone_number": "479-234-4499",
            "fax_number": "479-269-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1794 E JOYCE BLVD STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035257",
            "telephone_number": "479-234-4499",
            "fax_number": "479-269-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JTD MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "KAMERER",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-408-4466"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jtdmd@retina-arkansas.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1794 E Joyce Blvd Ste 3",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727035257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Rush Jordan, MS, PT
• Kathy Quarles Jordan, LCSW
• Shyni Joseph
• Hannah Joslin
• Jon Nathan Jowers, PT
• Matthew R Judah, PHD
• Hunter Judkins, M.D.
• Michael Jueneman, DPT
• Matt Juillerat, DO
• Ashton Brooke Julian, RDN

• Retina Specialist (Ophthalmology) Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Retina Specialist (Ophthalmology) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.