JAK ENTERPRISES, INC (NPI# 1295774859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295774859 |
| Entity Type | Organization |
| Organization Name | JAK ENTERPRISES, INC |
| Other Organization Name | BARD OPTICAL |
| Practice Address |
901 W Morton Ave 113 Jacksonville IL 62650-3145 |
| Mailing Address |
8309 N Knoxville Ave Peoria IL 61615-2170 |
| Practice Telephone | 2172436506 |
| Practice Fax Number | 2172434902 |
| Mailing Telephone | 3096939540 |
| Mailing Fax Number | 3096939542 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-06-05 |
| Authorized Official Name | DIANA J HALL (PRESIDENT) |
| Authorized Official Telephone | 3096939540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Bard Optical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629319330 | Jak Enterprises, Inc | Optometrist | 8309 N Knoxville Ave, Peoria, IL 61615-2170 | 2013-03-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | JAK ENTERPRISES, INC | 10906 E 6th Ave, Spokane, WA 99206 |
| Washington State Corporations | JAK ENTERPRISES, INC. | 601 S Pioneer Way Ste K, Moses Lake, WA 98837 |
| Street Address |
901 W MORTON AVE 113 |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154318749 | Charles E Atkins | Optometrist | 901 W Morton Ave, Ste 113, Jacksonville, IL 62650-3145 | 2005-09-29 |
| 1669658886 | William Sewell Montgomery | Physical Therapy Assistant | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3287 | 2008-01-17 |
| 1326233107 | Valerie Ernst | Physical Therapist | 901 W Morton Ave, S16a, Jacksonville, IL 62650-3287 | 2007-09-13 |
| 1902902687 | Kirsten Timmons | Nurse Practitioner | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3145 | 2006-09-16 |
| 1013013937 | Robert L. Gordon Jr. | Preventive Medicine | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3145 | 2006-09-16 |
| 1891748984 | Rebecca D. Ryan | Optometrist | 901 W Morton Ave, Ste. 113, Jacksonville, IL 62650-3145 | 2006-05-18 |
| 1982665063 | Darren P Ward | Physical Therapist | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3146 | 2006-03-29 |
| 1093775561 | Memorial Industrial Rehabilitation of Jacksonville | Physical Therapist | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3146 | 2006-03-27 |
| 1326008889 | Jennifer E Hart | Physical Therapy Assistant | 901 W Morton Ave, Suite 16a, Jacksonville, IL 62650-3146 | 2006-03-27 |
| 1487614939 | Donald P Rayhill | Occupational Therapist | 901 W Morton Ave, Suite 16 A, Jacksonville, IL 62650-3146 | 2006-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
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| 1215540562 | Christina Lorraine Jones | Durable Medical Equipment & Medical Supplies | 894 Plumbridge Ct, Jacksonville, FL 32218-6138 | 2020-08-26 |
| 1578175568 | Mob Enterprises LLC | Durable Medical Equipment & Medical Supplies | 5285 Shad Rd Ste 207, Jacksonville, FL 32257-2038 | 2020-08-20 |
| 1902456106 | Andre' Pollard | Durable Medical Equipment & Medical Supplies | 13700 Sutton Park Dr N Apt 1313, Jacksonville, FL 32224-2277 | 2019-09-19 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1285297838 | Medical Hotspots, Inc | Durable Medical Equipment & Medical Supplies | 5353 Ramona Blvd Ste 3, Jacksonville, FL 32205-4417 | 2019-04-18 |
| 1831657394 | Synergy Pharmacy Medical Consulting LLC | Durable Medical Equipment & Medical Supplies | 3517 Peeler Rd Apt 19, Jacksonville, FL 32277-2491 | 2019-03-04 |
| 1346707262 | Realo Discount Drug Stores of Eastern North Carolina Inc | Durable Medical Equipment & Medical Supplies | 461 Western Blvd Ste 122a, Jacksonville, NC 28546-7637 | 2019-02-27 |
| 1689131617 | Hughston Orthopaedic Southeast PC | Durable Medical Equipment & Medical Supplies | 6699 Gate Pkwy, Jacksonville, FL 32256-8078 | 2019-02-26 |
| 1457816548 | Ceylon Imports LLC | Durable Medical Equipment & Medical Supplies | 10435 Midtown Pkwy Unit 125, Jacksonville, FL 32246-7462 | 2019-02-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on JAK ENTERPRISES, INC.
| 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.