NPIMap

Organization Active NPI

Ronald M. Jackson, O.D. Chartered

Doing business as DBA Jackson & Baalman, Doctors of Optometry

  • Optometrist
  • Wichita, KS
National Provider Identifier
1912004557
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0982-3 Issued in KS
Legal business name
RONALD M. JACKSON, O.D. CHARTERED
Doing business as
DBA Jackson & Baalman, Doctors of Optometry
Practice address
982 N Tyler Rd
Suite a
Wichita, KS 67212-3271
Phone
(316) 722-6452
Fax
(316) 722-6001
NPI assigned
Sep 17, 2006
Last updated
Mar 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Ronald Morris Jackson, O.D.
Title
President
Phone
(316) 722-6452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1293-3 KS
Optometrist 152W00000X 0982-3 KS Primary

Addresses

Primary practice location

982 N Tyler Rd
Suite a
Wichita, KS 67212-3271

Mailing address

982 N Tyler Rd
Suite a
Wichita, KS 67212-3271
Phone (316) 722-6452

Other names 1

  • DBA Jackson & Baalman, Doctors of Optometry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1912004557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 N TYLER RD",
            "address_2": "SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123271",
            "telephone_number": "316-722-6452",
            "fax_number": "316-722-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 N TYLER RD",
            "address_2": "SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123271",
            "telephone_number": "316-722-6452",
            "fax_number": "316-722-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD M. JACKSON, O.D. CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-722-6452",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1293-3",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "0982-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Jackson & Baalman, Doctors of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.