Individual provider Active NPI

Marcie D Lewis, O.D.

  • Optometrist
  • Jackson, TN
National Provider Identifier
1083960314
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3052 Issued in TN
Practice address
145 Innovation Dr
Jackson, TN 38305-3019
Phone
(731) 422-0213
Fax
(731) 660-8368
NPI assigned
Jul 24, 2012
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3052 TN Primary

Addresses

Primary practice location

145 Innovation Dr
Jackson, TN 38305-3019

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752

Other names 1

  • Marcie Daniel Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151201001083 TN Practitioner - Optometry 5193941813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Optometrist CurrentSince May 9, 2016 Accepting new patients
Jackson Clinic PA CurrentSince May 9, 2016 Accepting new patients
West Tennessee Eye Care, PC Optometrist PastSince Jan 1, 2011 Accepting new patients
Corey Glenn Persons Optometrist Past Accepting new patients
Dr. Angela Milam & Associates, PLLC Optometrist PastSince Jan 1, 2020 Accepting new patients

Locations

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

145 Innovation Dr
Jackson, TN 38305

Interoperability endpoints

  • Direct secure messaging: marciedaniel@jcpa.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1083960314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-425-5752",
            "fax_number": "731-425-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 INNOVATION DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053019",
            "telephone_number": "731-422-0213",
            "fax_number": "731-660-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARCIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2023-10-25",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIE",
            "last_name": "DANIEL",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.