Individual provider Active NPI

Christine Farson Jackson, O.D.

  • Optometrist
  • Truckee, CA
National Provider Identifier
1992110274
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14996 Issued in CA
Practice address
10038 Meadow Way Unit a
Truckee, CA 96161-4974
Phone
(530) 587-1086
Fax
(530) 582-1929
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14996 CA Primary

Addresses

Primary practice location

10038 Meadow Way Unit a
Truckee, CA 96161-4974

Mailing address

PO Box 65
Truckee, CA 96160-0065
Phone (978) 502-2341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141006001452 CA Practitioner - Optometry 4486872538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truckee Family Eyecare Optometry IncGroup PAC ID 0749666246, 2 clinicians

Practice addresses (Care Compare)

10038 Meadow Way
Unit a
Truckee, CA 96161-4974
Phone (530) 587-1086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
805NVMDDermatology Physician
14996CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Truckee Family Eyecare Optometry, Inc Optometrist CurrentSince Aug 1, 2022 Accepting new patients

Locations

10038 Meadow Way
Unit A
Truckee, CA 96161
Phone (530) 426-2110

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1992110274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961600065",
            "telephone_number": "978-502-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10038 MEADOW WAY UNIT A",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961614974",
            "telephone_number": "530-587-1086",
            "fax_number": "530-582-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHRISTINE",
        "middle_name": "FARSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2023-12-08",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Truckee, CA

Sources for this page

Verify at the official NPI Registry.