Individual provider Active NPI

Jalen Thomas Cook

  • Optometrist
  • Bristol, TN
National Provider Identifier
1205675402
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3903 Issued in TN
Practice address
3185 W State St Ste 2010
Bristol, TN 37620-1600
Phone
(423) 968-7555
NPI assigned
May 20, 2024
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3903 TN Primary

Addresses

Primary practice location

3185 W State St Ste 2010
Bristol, TN 37620-1600

Mailing address

2010 Bremo Rd Ste 128a
Richmond, VA 23226-2444
Phone (423) 968-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240812001241 TN Practitioner - Optometry 1658819438 Reassigns benefits to 1 organization
I20240926000248 VA Practitioner - Optometry 1658819438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
East Tennessee State University Quillen College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Empire Eye Physicians, P.L.L.C.Group PAC ID 3870578248, 5 clinicians

Practice addresses (Care Compare)

224 Clay Dr
Pounding Mill, VA 24637-4320
Phone (888) 857-5033

3185 W State St
Suite 2010
Bristol, TN 37620-1600
Phone (423) 968-7555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123456789TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
David M Harman MD LLC Optometrist CurrentSince Jul 29, 2024 Accepting new patients
Mountain Empire Eye Physicians PLLC CurrentSince Jul 23, 2024 Accepting new patients

Locations

3185 W State St
Ste 2010
Bristol, TN 37620
Phone (423) 968-7555

2308 Cedar Valley Dr
Cedar Bluff, VA 24609
Phone (276) 964-4171

1825 Graves Mill Rd
Forest, VA 24551
Phone (434) 385-5650

224 Clay Dr
Pounding Mill, VA 24637
Phone (229) 395-9181

125 Suffolk Ave
Richlands, VA 24641
Phone (276) 963-0808

2010 Bremo Rd
Ste 128A
Richmond, VA 23226
Phone (804) 285-0680

135 Plaza Rd
Wise, VA 24293
Phone (540) 679-5612

137 Plaza Rd
Wise, VA 24293
Phone (276) 679-5612

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1205675402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BREMO RD STE 128A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262444",
            "telephone_number": "423-968-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 W STATE ST STE 2010",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201600",
            "telephone_number": "423-968-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JALEN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.