DR. JACOB JACQUES WANON (NPI# 1962600775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962600775 |
| Entity Type | Individual |
| Full Name | DR. JACOB JACQUES WANON |
| Credential | O.D. |
| Practice Address |
255 Western Ave Augusta ME 04330-4933 |
| Mailing Address |
210 Maine Ave Farmingdale ME 04344-4515 |
| Practice Telephone | 2076225800 |
| Mailing Telephone | 5102804910 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2012-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT924 | ME | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OPT13290T | CA | Eye and Vision Services Providers |
| Street Address |
255 WESTERN AVE |
| City | AUGUSTA |
| State | ME |
| Zip Code | 04330-4933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043394885 | Smart Vision, LLC | Eyewear Supplier (Equipment, not the service) | 255 Western Ave, Augusta, ME 04330-4933 | 2006-10-25 |
| 1366891434 | Nicholas A Holden | Optometrist | 255 Western Ave, Augusta, ME 04330-4933 | 2016-06-08 |
| 1336403286 | James S Brewer | Optometrist | 255 Western Ave, Augusta, ME 04330-4933 | 2012-06-26 |
| 1689677080 | Richard John Smart | Optometrist | 255 Western Ave, Augusta, ME 04330-4933 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1134748759 | Chelsea Simone Koch | Registered Nurse | 1 Va Center, Department of Veterans Affairs, Augusta, ME 04330 | 2020-04-14 |
| 1790238442 | Nicole Lacrosse | Behavioral Analyst | 53 Hayden Rd, Augusta, ME 04330 | 2016-07-29 |
| 1093176844 | Richard J. Larrabee | Counselor | 312 Townhouse Road, Chelsea, ME 04330 | 2016-03-08 |
| 1376910984 | Sarah C. A. Tatlock | Social Worker | 41 Anthony Ave, Augusta, ME 04330 | 2015-08-31 |
| 1457728180 | Va Maine Health | General Acute Care Hospital | 1 Va Center 05, Va Maine Healthcare System-togus, Augusta, ME 04330 | 2015-08-28 |
| 1043696842 | Megan Arsenault | Pharmacist | 403 Water Street, Augusta, ME 04330 | 2015-08-04 |
| 1205219987 | Trevor Holbert | Audiologist | 1 Va Center - Togus Va Medical Center, Audiology 126a, Augusta, ME 04330 | 2015-06-30 |
| 1659787836 | Hannah M. Pullen | Occupational Therapy Assistant | 12 Shuman Ave Ste 16, Augusta, ME 04330 | 2014-07-08 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in zip 04330 | ||||
| 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 |
|---|---|---|---|---|
| 1841587656 | Dale Rodrigue Eyecare Center, Inc | Optometrist | 58 State St, Augusta, ME 04330-5124 | 2011-06-30 |
| 1821303876 | Vision Value | Optometrist | 3899 Washington Rd, Augusta, GA 30907-2375 | 2010-08-15 |
| 1629262670 | Sponseller Eye Care One | Optometrist | 1456 Walton Way, Augusta, GA 30901-2674 | 2007-09-04 |
| 1326230657 | Anthony Kent Hartness | Optometrist | 706 Smiles Ave, Augusta, KS 67010-2385 | 2007-08-10 |
| 1336268903 | 1 Hour Optical P C | Optometrist | 2115 Windsor Spring Rd, Suite 23, Augusta, GA 30906-4855 | 2007-03-28 |
| 1679600258 | Donald Rene Carbonneau | Optometrist | 313 Water St, Augusta, ME 04330-4619 | 2007-02-28 |
| 1760566319 | Lance L Rittenhouse | Optometrist | 3440 Wrightsboro Rd, Augusta, GA 30909-2511 | 2006-10-24 |
| 1457447294 | Keisha Ann Williford | Optometrist | 217 Bobby Jones Expressway, Suite B, Augusta, GA 30907 | 2006-10-05 |
| 1013000744 | Abdul Babajide Daranijoh | Optometrist | 3412 Wrightsboro Rd, Suite 905, Augusta, GA 30909-2500 | 2006-10-02 |
| 1679667166 | Schwan Vision, LLC | Optometrist | 596 Bobby Jones Expy, Augusta, GA 30907-5300 | 2006-10-02 |
| Find all providers in AUGUSTA | ||||
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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.