JENNIFER M COSTALES (NPI# 1265744379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265744379 |
| Entity Type | Individual |
| Full Name | JENNIFER M COSTALES |
| Other Name | JENNIFER LEHMAN |
| Credential | O.D. |
| Practice Address |
345 Lindquist Rd Fort Stewart GA 31314-5043 |
| Mailing Address |
2200 Garden Hills Loop Richmond Hill GA 31324-6095 |
| Practice Telephone | 9128761101 |
| Mailing Telephone | 7249921917 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2019-08-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT002590 | GA | Eye and Vision Services Providers |
| Street Address |
345 LINDQUIST RD |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31314-5043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861402588 | Nacondus G Gamble | Optometrist | 345 Lindquist Rd, Building 71, Fort Stewart, GA 31314-5043 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733995 | Heather Ziccarelli Deneen | Dietitian, Registered | 441 Bultman Ave, 1183, Fort Stewart, GA 31314 | 2020-02-28 |
| 1073099826 | Ross Emerick | Dentist | 351 West 6th Street, Fort Stewart, GA 31314 | 2018-07-16 |
| 1184154742 | Roland Garcia | Dentist | 351 W 6th St Bldg 440, Ft Stewart, GA 31314 | 2017-06-15 |
| 1548613045 | Sylvia Mclean | Dental Hygienist | 343 Vanguard Road, Fort Stewart, GA 31314 | 2016-07-20 |
| 1407209257 | David Wald Jr. | Dental Hygienist | 305 Vanguard Rd. Bldg 8335, Fort Stewar, GA 31314 | 2016-07-18 |
| 1376995415 | Alisha Potter | Dental Assistant | 305 Vangurard Road, Ft Stewart, GA 31314 | 2016-07-12 |
| 1538511068 | Brandi Harris | Dental Assistant | 305 Vanguard Rd, Ft Stewart, GA 31314 | 2016-07-08 |
| 1548612088 | Adrian Cuthbert | Dental Assistant | 305 Vanguard Road, Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1841642386 | Beverly Lynn Berry | Dental Assistant | 306 Vanguard Road Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1740630060 | Anjanette Nicole' Brown | Dental Assistant | 706 Warriors Rd, Building 2115, Fort Stewart, GA 31314 | 2016-06-17 |
| Find all providers in zip 31314 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861402588 | Nacondus G Gamble | Optometrist | 345 Lindquist Rd, Building 71, Fort Stewart, GA 31314-5043 | 2006-08-08 |
| 1285617969 | Susan Mazuji Sloan | Optometrist | 1061 Harmon Ave, Optometry, Winn Army Community Hospital, Fort Stewart, GA 31314 | 2005-11-28 |
| 1942850045 | Brandon David Southern | Optometrist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2019-09-19 |
| 1972085165 | Nicolle Oberlin | Optometrist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2018-09-04 |
| 1962873182 | Alex Falb | Optometrist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2015-10-14 |
| 1659652469 | Steven I Kim | Optometrist | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2011-09-07 |
| 1134431653 | Cesar A Costales | Optometrist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2010-07-13 |
| 1306013669 | Paul Evan Webb | Optometrist | 1061 Harmon Ave, Suite 1d03, Fort Stewart, GA 31314-5641 | 2008-05-14 |
| 1629258819 | Brad Cunningham | Optometrist | 1061 Harmon Ave, Optometry Clinic, Fort Stewart, GA 31314-5641 | 2007-11-06 |
| 1578762670 | Peter Thomas | Optometrist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2007-07-17 |
| Find all providers in FORT STEWART | ||||
| City | FORT STEWART |
| Zip Code | 31314 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.