James L Ducklo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT 1233 Issued in TN

Practice address

5252 Hickory Hollow Pkwy
Suite 1133
Antioch, TN 37013-3005

Phone

(615) 731-6230

Fax

(615) 731-6538

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TN

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

Southern College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lavanya Tammareddi, O.D.

  • Optometrist
  • Mount Juliet, TN
  • NPI 1174690655
  Medicare reassignment

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.

• Murfreesboro Eye Center PLLC

  dba Mount Juliet Eye Center

  • Optometrist
  • Murfreesboro, TN
  • NPI 1407589195
  NPD
• James L Ducklo OD

  dba James L Ducklo Od and Associates

  • Optometrist
  • Antioch, TN
  • NPI 1285786145
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1194764365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 HICKORY HOLLOW PKWY",
            "address_2": "SUITE 1133",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133005",
            "telephone_number": "615-731-6230",
            "fax_number": "615-731-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 HICKORY HOLLOW PKWY",
            "address_2": "SUITE 1133",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133005",
            "telephone_number": "615-731-6230",
            "fax_number": "615-731-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKLO",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT 1233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE SYSTE",
            "identifier": "621429478",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "621429478",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL",
            "identifier": "621429478",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3597450",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0118062",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR",
            "identifier": "621429478",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myrlande Dixon, PA-C
• Latonya Dotson
• Kyndra Jones Dove, PHARMD
• Dr Mark Lynn & Associates PLLC (Visionworks Doctors of Optometry)
• Brandy Micole Drumwright, CCC-SLP
• Augustina Chidiebere Durunna
• Patricia Louise Eachus, M.D.
• Eagle Eye Transportation LLC
• Eagle Eyecare PLLC
• Early Bird Transportation LLC

• Optometrist in Antioch, TN
• Providers in Antioch, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.