Individual provider Active NPI

Leslie Renee Jones, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1104635390
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1103 Issued in MS
Practice address
3 Lydgate Ave
Memphis, TN 38109-4523
Phone
(901) 857-0054
NPI assigned
Jan 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1103 MS Primary

Addresses

Primary practice location

3 Lydgate Ave
Memphis, TN 38109-4523

Mailing address

3 Lydgate Ave
Memphis, TN 38109-4523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20250219002731 MS Practitioner - Optometry 8022538115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Vision Services LLCGroup PAC ID 8820256001, 9 clinicians

Practice addresses (Care Compare)

837 Kings Crossing Dr
Suite 10
Tupelo, MS 38804-0952
Phone (888) 840-3032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1103MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Vision Services LLC Optometrist CurrentSince Feb 24, 2025 Accepting new patients

Locations

837 Kings Crossing Dr
Ste 10
Tupelo, MS 38804
Phone (662) 269-4175

10826 Old Mill Rd
Ste 101
Omaha, NE 68154

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1104635390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYDGATE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381094523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYDGATE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381094523",
            "telephone_number": "901-857-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LESLIE",
        "middle_name": "RENEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.