DR. JERRY LEE MARTIN (NPI# 1679543821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679543821 |
| Entity Type | Individual |
| Full Name | DR. JERRY LEE MARTIN |
| Credential | O.D. |
| Practice Address |
1745 W Avenue K Lancaster CA 93534-6502 |
| Practice Telephone | 6619428437 |
| Practice Fax Number | 6619401959 |
| Mailing Telephone | 6619428437 |
| Mailing Fax Number | 6619401959 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2009-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT6288TPL | CA | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
OPT6288TPL | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MESC PROVIDER NUMBER | 6169 | 01 |
| CA | DAVIS VISION PROVIDER NUM | 2673 | 01 |
| CA | B/C B/S IDENTIFIER | SD0062880 | 01 |
| CA | B/C B/S GROUP IDENTIFIER | ZZ40293Z | 01 |
| CA | RAILROAD MEDICARE NUMBER | 410016191 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306229968 | Jerry Wayne Martin | Family Medicine | 2162 Nashville Road, Bowling Green, KY 42101-3849 | 2015-07-01 |
| 1821415571 | Jerry Nell Martin | Registered Nurse | 531 David W Ray Dr, Georgetown, SC 29440-6693 | 2014-03-19 |
| 1437240157 | Jerry H. Martin | Dentist | 4150 Douglas Blvd, # A, Granite Bay, CA 95746-5964 | 2006-09-27 |
| 1235239344 | Jerry D Martin | Dentist | 418 W. Monroe Ave., Chester, MT 59522-0516 | 2006-09-25 |
| 1992730832 | Jerry Wayne Martin | Family Medicine | 338 Gay Street, Suite A, Washington, VA 22747-0269 | 2006-07-11 |
| 1336112549 | Jerry L. Martin | Physician Assistant | 150 Page Rd, Robins Afb, GA 31098-1600 | 2006-02-08 |
| 1831184332 | Jerry K Martin Jr. | Obstetrics & Gynecology | 900 Earl Frye Blvd Ste A, Amory, MS 38821-5507 | 2005-09-12 |
| 1083064562 | Jerry Martin | Counselor | 4411 N Cedar Ave Ste 108, Fresno, CA 93726-2538 | 2016-06-15 |
| 1013172733 | Jerry Vann Martin | Emergency Medicine | 2500 Mowry Ave, Suite 212, Fremont, CA 94538-1605 | 2008-07-22 |
| 1588853709 | Jerry Martin Jr. | Counselor | 2918 W Vernon Ave, Los Angeles, CA 90008-4757 | 2007-10-24 |
| Street Address |
1745 W AVENUE K |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-6502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942442777 | Southwest Dental Center Inc. | Dentist | 1745 W Avenue K, Suite C, Lancaster, CA 93534-6501 | 2009-03-25 |
| 1861682759 | Dr. Yury B. Geylikman, A Professional Dental Corporation | Dentist | 1745 W Avenue K, Suite C, Lancaster, CA 93534-6501 | 2007-07-27 |
| 1407867161 | Richard Nels Petersen | Optometrist | 1745 W Avenue K, Suite A, Lancaster, CA 93534-6502 | 2006-08-10 |
| 1548202864 | Antelope Valley Optometric Center, Inc. | Optometrist | 1745 W Avenue K, Suite A, Lancaster, CA 93534-6501 | 2006-06-12 |
| 1568432730 | Michael Lee Holub | Optometrist | 1745 W Avenue K, Suite A, Lancaster, CA 93534-6502 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| 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 |
|---|---|---|---|---|
| 1770104549 | Erica Jill Bobb | Optometrist | 3029 Oliver Stanley Trl, Lancaster, SC 29720-0286 | 2020-05-02 |
| 1598304446 | Jenny Huong Le, O.d., A Professional Corporation | Optometrist | 44407 10th St W Ste B, Lancaster, CA 93534-3345 | 2019-12-24 |
| 1972155901 | Vivian Li | Optometrist | 1643 Lititz Pike, Lancaster, PA 17601-6507 | 2019-07-10 |
| 1053973263 | Tiffany Phuong | Optometrist | 1635 Manheim Pike, Lancaster, PA 17601-3027 | 2019-07-08 |
| 1952962771 | Allison Cramer Brun | Optometrist | 422 N Queen St Fl 2, Lancaster, PA 17603-3014 | 2019-06-24 |
| 1851951362 | Christian Matthew Wyler | Optometrist | 304 Stanford St, Lancaster, KY 40444 | 2019-06-17 |
| 1841641271 | Kristin Nikolle Goodling | Optometrist | 2221 Noll Drive, Lancaster, PA 17603-7610 | 2016-06-27 |
| 1295159457 | Vu & Shaghoyan An Optometric Professional Corporation | Optometrist | 516 W Lancaster Blvd, Lancaster, CA 93534-2516 | 2014-02-09 |
| 1407132848 | Dbs Eye Care LLC | Optometrist | 1622 N Memorial Dr, Lancaster, OH 43130-1631 | 2011-10-31 |
| 1114220738 | August M Wallace Enterprises, LLC | Optometrist | 805 Highway 9 Byp W, Lancaster, SC 29720 | 2010-12-21 |
| Find all providers in LANCASTER | ||||
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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.