Jeremy Wade Anderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2431 Issued in TN

Practice address

1642 McArthur St
Manchester, TN 37355-2522

Phone

(931) 728-1315

Fax

(931) 728-1779

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Specialty

Optometry

Education

Southern College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hermitage Eye Care, PLLCGroup PAC ID 0446576359, 48 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Hermitage Eye Care PLLC

  • Optometrist
  • Hermitage, TN
  • NPI 1275943052
  Medicare reassignment Care Compare group NPD
• Anderson Eye Care, PLLC

  • Optometrist
  • Manchester, TN
  • NPI 1952635690

  TN

  Medicare reassignment Authorized official
• Hermitage Eye Care PLLC

  • Optometrist
  • Brentwood, TN
  • NPI 1689479909
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1063405256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552522",
            "telephone_number": "931-728-1315",
            "fax_number": "931-728-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552522",
            "telephone_number": "931-728-1315",
            "fax_number": "931-728-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEREMY",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE OD",
            "identifier": "2431",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3946295",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Daniel Allen, FNP
• Mary Alliot-Stewart, PTA
• Amg-Southern Tennessee LLC
• Anderson Eye Care, PLLC
• Christy Anderson
• Summer Truesdale Anderson, O.D.
• Apex Medical Equipment, Inc.
• Laura Ayers, LCSW
• Bailey Manor
• Baker Brothers Drug Inc -New Corp

• All providers in Manchester, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.