Active NPI
Jimmy D. Bartlett, O.D.
- Optometrist
- Birmingham, AL
National Provider Identifier
1164430203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T-29-TA-008
- Practice address
- 1716 University Blvd
HPB G080A
Birmingham, AL 35294-0010 - Phone
- (205) 975-2020
- Fax
- (205) 934-6755
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
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 | T-29-TA-008 | AL | Primary |
Addresses
Primary practice location
1716 University Blvd
HPB G080A
Birmingham, AL 35294-0010
Mailing address
1716 University Blvd
HPB Go80A
Birmingham, AL 35294-0010
Phone (205) 934-4748
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51059862 | Other | AL | BLUE CROSS BLUE SHIELD OF |
| 1585904 | Medicaid | LA | |
| 08304066 | Medicaid | MS | |
| 000059862 | Medicaid | AL | |
| 1716A 636005396 | Other | VISION SERVICES PLAN | |
| T69119 | Other | AL | VIVA HEALTHCARE |
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": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1164430203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 UNIVERSITY BLVD",
"address_2": "HPB GO80A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352940010",
"telephone_number": "205-934-4748",
"fax_number": "205-934-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 UNIVERSITY BLVD",
"address_2": "HPB G080A",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352940010",
"telephone_number": "205-975-2020",
"fax_number": "205-934-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTLETT",
"first_name": "JIMMY",
"middle_name": "D.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "T-29-TA-008",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF",
"identifier": "51059862",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1585904",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08304066",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000059862",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISION SERVICES PLAN",
"identifier": "1716A 636005396",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA HEALTHCARE",
"identifier": "T69119",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.