Provider Demographics
NPI:1801999362
Name:JURY, JAMES S (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:JURY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:926 E DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3510
Mailing Address - Country:US
Mailing Address - Phone:316-247-6515
Mailing Address - Fax:678-928-0651
Practice Address - Street 1:926 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3510
Practice Address - Country:US
Practice Address - Phone:316-247-6515
Practice Address - Fax:678-928-0651
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1282-3152W00000X
KS1282152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200622550AMedicaid
KS670668OtherBCBS OF KS
KS017160OtherBCBS OF KS
651667OtherBCBS OF KANSAS
KS017160OtherBCBS OF KS
651667OtherBCBS OF KANSAS
KS0229890001Medicare NSC
KS200622550AMedicaid