Active NPI
Jacqueline Burgess, OD
- Optometrist
- Knoxville, TN
National Provider Identifier
1154858116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3452
- Practice address
- 1521 Downtown West Blvd
Knoxville, TN 37919-5407 - Phone
- (865) 545-4592
- NPI assigned
- May 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3452 | TN | Primary |
Addresses
Primary practice location
1521 Downtown West Blvd
Knoxville, TN 37919-5407
Mailing address
1521 Downtown West Blvd
Knoxville, TN 37919-5407
Phone (865) 545-4592
Other practice location 1
Lamont St. & Veterans Way
Eye Clinic Building 200
Mountain Home, TN 37684
Phone (423) 926-1171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591833600000",
"number": "1154858116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 DOWNTOWN WEST BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195407",
"telephone_number": "865-545-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 DOWNTOWN WEST BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195407",
"telephone_number": "865-545-4592"
}
],
"practiceLocations": [
{
"address_1": "Lamont St. & Veterans Way",
"address_2": "Eye Clinic Building 200",
"address_purpose": "LOCATION",
"city": "Mountain Home",
"state": "TN",
"postal_code": "37684",
"country_code": "US",
"telephone_number": "423-926-1171",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BURGESS",
"first_name": "JACQUELINE",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-21",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "TN",
"license": "3452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.