H Jack Fennel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5114T Issued in CA

Practice address

1031 Washington St
Red Bluff, CA 96080

Phone

(530) 527-2211

Fax

(530) 527-7412

NPI assigned

Jul 21, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1962423582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 WASHINGTON ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "96080",
            "telephone_number": "530-527-2211",
            "fax_number": "530-527-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 WASHINGTON ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "96080",
            "telephone_number": "530-527-2211",
            "fax_number": "530-527-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEL",
        "first_name": "H",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5114T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0051140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Ewing, FNP
• Jennifer Michelle Fagundes
• Sanjiv Girish Faldu, M.D.
• Family Service Agency of Tehama County (Family Counseling Center)
• Michelle Cortney Fay
• Lindsey Ferguson
• Courtney Marie Fernea
• Garry D. Fish, O.D.
• Gregory Walsh Fisher
• Lenea Garber Fisher

• Optometrist in Red Bluff, CA
• Providers in Red Bluff, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.