Individual provider Active NPI

Jennifer Marshall Jaikaran, O.D.

  • Optometrist
  • Alpharetta, GA
National Provider Identifier
1922043496
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 002111 Issued in GA
Practice address
3975 Old Milton Pkwy
Alpharetta, GA 30005-4467
Phone
(678) 624-7766
Fax
(678) 624-7775
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4030 FL
Optometrist 152W00000X OPT 002111 GA Primary

Addresses

Primary practice location

3975 Old Milton Pkwy
Alpharetta, GA 30005-4467

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

3975 Old Milton Pkwy
Alpharetta, GA 30005-4467
Phone (678) 624-7766

Other practice location 2

6750 Jamestown Drive
Alpharetta, GA 30005
Phone (678) 691-0073

Other identifiers 1

IdentifierTypeStateIssuer
304425559AMedicaidGA

Other names 1

  • Dr. Jennifer Karen Marshall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20031211000001 GA Practitioner - Optometry 3375449275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

3975 Old Milton Pkwy
Suite 2
Alpharetta, GA 30005-4467
Phone (678) 624-7766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4030FLMDOptometrist
OPT 002111GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Dec 5, 2017 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Dec 5, 2017 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist PastSince Dec 16, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist PastSince Dec 16, 2020 Accepting new patients

Locations

3975 Old Milton Pkwy
Ste 2
Alpharetta, GA 30005
Phone (678) 624-7766

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

5940 Roswell Rd
Sandy Springs, GA 30328
Phone (404) 843-2020

1000 Peachtree Industrial Blvd
Ste 14
Suwanee, GA 30024
Phone (770) 271-0611

1000 Peachtree Industrial Blvd
Suwanee, GA 30024
Phone (770) 271-0611

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1922043496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 OLD MILTON PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054467",
            "telephone_number": "678-624-7766",
            "fax_number": "678-624-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 Old Milton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300054467",
            "country_code": "US",
            "telephone_number": "678-624-7766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6750 Jamestown Drive",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "30005",
            "country_code": "US",
            "telephone_number": "678-691-0073",
            "fax_number": "888-707-4495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIKARAN",
        "first_name": "JENNIFER",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4030",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT 002111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304425559A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARSHALL",
            "middle_name": "KAREN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.