Individual provider Active NPI

Matthew Edgar Jones, OD

  • Optometrist
  • Blytheville, AR
National Provider Identifier
1144468679
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2623 Issued in AR
Practice address
527 N 6TH St
Suite a
Blytheville, AR 72315-2407
Phone
(870) 762-2297
Fax
(870) 763-2552
NPI assigned
Jan 21, 2009
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 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 2623 AR Primary

Addresses

Primary practice location

527 N 6TH St
Suite a
Blytheville, AR 72315-2407

Mailing address

527 N 6TH St
Suite a
Blytheville, AR 72315-2407
Phone (870) 762-2297

Other identifiers 1

IdentifierTypeStateIssuer
180304722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20091117000513 AR Practitioner - Optometry 6709931058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
R Dean Gurley OD PAGroup PAC ID 0345391611, 7 clinicians

Practice addresses (Care Compare)

401 W Hale Ave
Osceola, AR 72370-2531
Phone (870) 563-3800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
R Dean Gurley OD PA Optometrist CurrentSince Sep 26, 2009 Accepting new patients
Barry L Harris, OD, PA Optometrist CurrentSince Jul 1, 2022 Accepting new patients

Locations

527 N 6th St
Blytheville, AR 72315
Phone (870) 762-2297

527 N 6th St
Ste A
Blytheville, AR 72315
Phone (870) 762-2297

401 W Hale Ave
Osceola, AR 72370
Phone (870) 563-3800

901 Linwood Dr
Paragould, AR 72450
Phone (870) 239-2251

303 W Polk Ave
West Memphis, AR 72301
Phone (423) 483-4496

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Mississippi County Regional Medical CenterOsceola, AR, CCN 040782 Hospital Corporate Director Feb 29, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1144468679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 N 6TH ST",
            "address_2": "SUITE A",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "870-762-2297",
            "fax_number": "870-763-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 N 6TH ST",
            "address_2": "SUITE A",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "870-762-2297",
            "fax_number": "870-763-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MATTHEW",
        "middle_name": "EDGAR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180304722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.