Individual provider Active NPI

Jennifer Oakley, M.D.

  • Ophthalmology Physician
  • Johnson City, TN
National Provider Identifier
1104081918
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
50435 Issued in TN
Practice address
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone
(423) 929-2111
Fax
(423) 929-0497
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X T-2130 MS
Ophthalmology Physician 207W00000X 50435 TN Primary

Addresses

Primary practice location

110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004

Mailing address

110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131108001093 TN Practitioner - Ophthalmology 3870728314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Brody School of Medicine at East Carolina University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson City Eye Clinic PCGroup PAC ID 3375448681, 11 clinicians

Practice addresses (Care Compare)

110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-2130MSMDOphthalmology Physician
50435TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson City Eye Clinic PC Ophthalmology CurrentSince Nov 1, 2013 Accepting new patients

Locations

321 Midway Medical Park
Ste 2
Bristol, TN 37620
Phone (276) 783-5157

225 Midway Medical Park
Bristol, TN 37620
Phone (423) 797-4555

110 Med Tech Pkwy
Ste 2
Johnson City, TN 37604
Phone (423) 722-0371

110 Med Tech Pkwy
Ste 1
Johnson City, TN 37604
Phone 42392921113414

110 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 722-0371

Organizations & group practices 1

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1104081918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MED TECH PKWY",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044004",
            "telephone_number": "423-929-2111",
            "fax_number": "423-929-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MED TECH PKWY",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044004",
            "telephone_number": "423-929-2111",
            "fax_number": "423-929-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OAKLEY",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "T-2130",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "50435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.