Jeremy Daniel Edgerly, O.D.
Individual provider Active NPI Optometrist · Mountain Brook, AL
NPI 1003177296 · NPPES record last updated May 4, 2026
Key facts
- NPI
- 1003177296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- S-C78 (AL)
- Practice address
- 921 Jemison LN
Mountain Brook, AL 35223-3003 - Phone
- (205) 341-9595
- Fax
- (205) 341-9941
- NPI assigned
- Jun 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University of Alabama School of Medicine, 2012
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Marx Optical Inc
Practice addresses (Care Compare)
2620 Centron Dr SW
Decatur, AL 35603-2500
Phone (256) 350-6655
921 Jemison Lane
Mountain Brook, AL 35223-3003
Phone (205) 341-9595
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130924000569 | AL | Practitioner - Optometry | 4880838390 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-C78 | AL | MD | Optometrist |
Practice roles (2 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marx Optical Inc | Current |
Accepting new patients | |
| Jeremy Edgerly, OD, LLC | Optometrist | Current |
Accepting new patients |
Locations
2620 Centron Dr SW
Decatur, AL 35603
Phone (256) 350-2020
921 Jemison Ln
Mountain Brook, AL 35223
Phone (205) 341-9595
Networks
- TN PPO
- AL HMO
- TN PPO C-SNP
- AL HMO D-SNP
- MS PPO C-SNP
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
- MS PPO D-SNP
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
- MS PPO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S-C78 | AL | Yes |
Addresses
Primary practice location
921 Jemison LN
Mountain Brook, AL 35223-3003
Mailing address
921 Jemison LN
Mountain Brook, AL 35223-3003
Phone (205) 341-9595
Other providers in Mountain Brook, AL
- Alabama CVS Pharmacy, L.L.C.
- Back on Track Chiropractic and Wellness Center PC
- Daymark Pastoral Counseling
- Tommy Gene Foster Jr.
- Heidi Bullock Counseling LLC
- HGD, Inc
- J Walden Retan MD PC
- Jeremy Edgerly, OD, LLC
All providers in Mountain Brook, AL · Optometrist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.