Jacqueline Rose Fiddler, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3700 Issued in TN

Practice address

11860 Cranston Dr
Arlington, TN 38002-4886

Phone

(901) 867-5540

NPI assigned

Jun 11, 2020

Last updated

Jul 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• MS PPO
• MS PPO C-SNP
• KY PPO
• MS PPO D-SNP
• KY PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern College of Optometry

  • Optometrist
  • Memphis, TN
  • NPI 1851384986
  Medicare reassignment Care Compare group NPD
• Dr. Angela Milam & Associates, PLLC

  dba Angel Eyes Vision

  • Optometrist
  • Memphis, TN
  • NPI 1689270464
  Medicare reassignment NPD
• Primary Eyecare, PLC

  dba Primary Eye Care of Arlington

  • Optometrist
  • Arlington, TN
  • NPI 1952563744
  Medicare reassignment NPD
• Nu-Crown, LLC

  dba Crown Optical

  • Optometrist
  • Alton, IL
  • NPI 1295737294

  MO

  Medicare reassignment
• Southern College of Optometry

  dba University Eye Care

  • Optometrist
  • Memphis, TN
  • NPI 1518309202
  NPD (past)
• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD (past)
• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1013532480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11860 CRANSTON DR",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380024886",
            "telephone_number": "901-867-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11860 CRANSTON DR",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380024886",
            "telephone_number": "901-867-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDDLER",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2020014960",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Michele Erskine, PHARMD
• Everwell CLS Home LLC
• Faith Family Medical Services
• Fast Pace Medical Clinic PLLC
• Melissa Felix
• Andrenette M Fleming, MD
• Brea Nicole Fleming, DDS
• Meghan Taby Foster
• Gallaway One, LLC.
• Sharon C Gant, FNP-C

• Optometrist in Arlington, TN
• Providers in Arlington, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.