Individual provider Active NPI

Joel Francis Allison, O.D.

  • Optometrist
  • Jackson, MO
National Provider Identifier
1962664151
Registry record updated Jun 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03308 Issued in MO
Practice address
3051 E Jackson Blvd
Jackson, MO 63755-2910
Phone
(573) 204-7301
Fax
(573) 204-7304
NPI assigned
Jun 28, 2008
Last updated
Jun 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03308 MO Primary

Addresses

Primary practice location

3051 E Jackson Blvd
Jackson, MO 63755-2910

Mailing address

3051 E Jackson Blvd
Jackson, MO 63755-2910
Phone (573) 204-7301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T03308MOMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1214611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214611200000",
    "number": "1962664151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552910",
            "telephone_number": "573-204-7301",
            "fax_number": "573-204-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552910",
            "telephone_number": "573-204-7301",
            "fax_number": "573-204-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "JOEL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-28",
        "last_updated": "2008-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2008; 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.