NPIMap

Organization Active NPI

Jartll Corp

  • Optometrist
  • Southfield, MI
National Provider Identifier
1952420267
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JARTLL CORP
Practice address
29983 Northwestern Hwy
Southfield, MI 48034-1020
Phone
(248) 358-2920
NPI assigned
Mar 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Heather M Kingery
Title
Insurance Supervisor
Phone
(248) 871-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

29983 Northwestern Hwy
Southfield, MI 48034-1020

Mailing address

27620 Farmington Rd
Ste 106
Farmington Hills, MI 48334-3349
Phone (248) 871-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070503000237 MI Part B Supplier - Clinic/Group Practice 3274639596 Receives reassigned benefits from 8 practitioners
4 other NPIs on this enrollment
Practice locations: Auburn Hills, MI; Bloomfield Hills, MI; Detroit, MI; Rochester, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jartll Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

27620 Farmington Rd
Ste 106
Farmington Hills, MI 48334

Practitioners & affiliated clinicians

Practitioners 8

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952420267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27620 FARMINGTON RD",
            "address_2": "STE 106",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343349",
            "telephone_number": "248-871-1234",
            "fax_number": "248-871-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29983 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341020",
            "telephone_number": "248-358-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARTLL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KINGERY",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE SUPERVISOR",
        "authorized_official_telephone_number": "248-871-1234"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.