Phillip Bryan Tickner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-B65-TA-769 Issued in AL

Practice address

8551 Whitfield Ave
Leeds, AL 35094-7560

Phone

(205) 655-0719

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

University Alabama Birmingham - School of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Phillip B Tickner OD & Associates LLC

  • Optometrist
  • Leeds, AL
  • NPI 1578890885
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1124211990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ANDERSON CIR",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351731001",
            "telephone_number": "205-919-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 WHITFIELD AVE",
            "city": "LEEDS",
            "state": "AL",
            "postal_code": "350947560",
            "telephone_number": "205-655-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKNER",
        "first_name": "PHILLIP",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-B65-TA-769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayna Teer
• The Approach Forward, LLC
• The Solace Group
• Therapy South Leeds LLC
• Lacey Thrower-Phillips
• Linh Chuc Tran, D.M.D
• Phillip Turner, MS
• Abigail Underwood
• Brittnee Vann
• Glorian Caroline Vaughn, PHARMD

• Optometrist in Leeds, AL
• Providers in Leeds, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.