Walter Lee Jackson II, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003364 Issued in GA

Practice address

2616 Warm Springs Road
Columbus, GA 31904-5323

Phone

(706) 507-7530

Fax

(706) 221-9797

NPI assigned

Jun 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, GA2 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 Alabama Birmingham - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Georgia Eye Care Center,P.a.Group PAC ID 9436147972, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.55 of 100Reported as group

Quality

91.11

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: walter.jacksonii.p4@direct.clemsoneye.nextgenshare.com

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.

• West Georgia Eye Care Center, PA

  • Ophthalmology Physician
  • Columbus, GA
  • NPI 1699868265
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Alabama LLC

  dba MyEyeDr.

  • Optometrist
  • Tuscaloosa, AL
  • NPI 1770093551
  Medicare reassignment NPD
• Myeyedr Optometry of Alabama LLC

  dba MyEyeDr

  • Optometrist
  • Pelham, AL
  • NPI 1639644685
  NPD
• Myeyedr Optometry of Alabama, LLC

  dba MyEyeDr.

  • Optometrist
  • Cullman, AL
  • NPI 1104488055
  NPD
• West Georgia Medical Associates

  • Dermatology Physician
  • Columbus, GA
  • NPI 1174972434
  NPD (past)

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1073180741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468575",
            "telephone_number": "864-359-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 WARM SPRINGS ROAD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319045323",
            "telephone_number": "706-507-7530",
            "fax_number": "706-221-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2012 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319011460",
            "country_code": "US",
            "telephone_number": "706-323-3491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 Whittlesey Blvd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "31909",
            "country_code": "US",
            "telephone_number": "706-323-3491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "WALTER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "AL",
            "license": "S-E78",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "AL",
            "license": "S-E78-TA-C17",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "AL",
            "license": "S-E78",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "AL",
            "license": "S-E78-TA-C17",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003364",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E78",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E78-TA-C17",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shakiatra Jackson
• Theresa Jackson
• Travis Jackson
• Trina Freeman Jackson
• Walter Hugh Jackson III, DDS
• Wykey Jackson
• April Michelle Jacobs, M.S.
• Deanna Jacobs, RBT
• Jillian Welch Jacobs, FNP-C
• Reginald Jerome Jacobs II

• Optometrist in Columbus, GA
• Providers in Columbus, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.