Jenna M Jeffries OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JENNA M JEFFRIES OD LLC

Practice address

3200 Atlantic Blvd NE
Canton, OH 44705-3933

Phone

(330) 489-9145

Fax

(330) 489-9147

NPI assigned

Sep 10, 2021

Organization subpart

No

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

Authorized official

Name

Jenna M Jeffries, ODNPI 1679988216

Title

Owner

Phone

(330) 489-9145

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jenna Jeffries, O.D.

  • Optometrist
  • Canton, OH
  • NPI 1679988216
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1922777135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 ATLANTIC BLVD NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447053933",
            "telephone_number": "330-489-9145",
            "fax_number": "330-489-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 ATLANTIC BLVD NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447053933",
            "telephone_number": "330-489-9145",
            "fax_number": "330-489-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNA M JEFFRIES OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "JEFFRIES",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-489-9145",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leta Janeen Jenkins
• Tami D Jenkins
• Tatyana Jenkins, RN
• Toby Katherine Jenkins
• William A. Jenkins Jr.
• Abigail Jennings
• Laressa Jennings
• Shayna Jennings
• Sierra Jennings
• Toniqua D Jennings

• Optometrist in Canton, OH
• Providers in Canton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.