Jonathan Blake Ross, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2493 Issued in AR

Practice address

1815 E Highland Dr
Jonesboro, AR 72401-6118

Phone

(870) 931-2020

Fax

(870) 932-8004

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Optometry

Education

Southern College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kelly G Ross OD PAGroup PAC ID 7214982321, 2 clinicians

Jonathan B. Ross OD PAGroup PAC ID 0840356721, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Jonathan B. Ross OD PA

  dba ross vision care center

  • Optometrist
  • Jonesboro, AR
  • NPI 1225196132
  Medicare reassignment Care Compare group NPD Authorized official
• Kelly G Ross OD PA

  dba ross eye care center

  • Optometrist
  • Walnut Ridge, AR
  • NPI 1982760955
  Medicare reassignment Care Compare group NPD
• Southern Eye Associates, LTD

  • Optometrist
  • Walnut Ridge, AR
  • NPI 1215025119
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1881638328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 RIVIERA DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724046874",
            "telephone_number": "870-934-8680",
            "fax_number": "870-932-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E HIGHLAND DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016118",
            "telephone_number": "870-931-2020",
            "fax_number": "870-932-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JONATHAN",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141013722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BC/BS",
            "identifier": "49648",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synitrious Rose
• Erik Rosenlof, D.P.M.
• Theresa Rosentritt, HIS
• Angela Ross
• Jeanne C Ross, MD
• Sandra Kay Ross, M.R.C., L.P.C.
• Shaina Ross, OTR
• David E Rosson
• Tisha R Roswell, LCSW
• William B Roth, DO

• Optometrist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.