Individual provider Active NPI

Jessica Lynn Pearson, OD

  • Optometrist
  • Blytheville, AR
National Provider Identifier
1972358992
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2889 Issued in AR
Practice address
527 N 6TH St
Blytheville, AR 72315-2407
Phone
(870) 729-1279
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 2889 AR Primary

Addresses

Primary practice location

527 N 6TH St
Blytheville, AR 72315-2407

Mailing address

20806 State Highway 164
Hornersville, MO 63855
Phone (731) 487-5338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20240813004382 AR Practitioner - Optometry 7719425370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
R Dean Gurley OD PAGroup PAC ID 0345391611, 7 clinicians

Practice addresses (Care Compare)

527 N 6TH St
Blytheville, AR 72315-2407
Phone (870) 762-2297

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
R Dean Gurley OD PA Optometrist CurrentSince Jul 15, 2024 Accepting new patients

Locations

527 N 6th St
Blytheville, AR 72315
Phone (870) 762-2297

527 N 6th St
Ste A
Blytheville, AR 72315
Phone (870) 762-2297

401 W Hale Ave
Osceola, AR 72370
Phone (870) 563-3800

Organizations & group practices 1

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1972358992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20806 STATE HIGHWAY 164",
            "city": "HORNERSVILLE",
            "state": "MO",
            "postal_code": "63855",
            "telephone_number": "731-487-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 N 6TH ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "870-729-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.