Individual provider Active NPI

Timothy Garland Jessee, O.D.

  • Optometrist
  • Salem, VA
National Provider Identifier
1225143639
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000391 Issued in VA
Practice address
1851 W Main St
Salem, VA 24153-3111
Phone
(540) 375-3937
Fax
(540) 387-4219
NPI assigned
Aug 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000391 VA Primary

Addresses

Primary practice location

1851 W Main St
Salem, VA 24153-3111

Mailing address

1851 W Main St
Salem, VA 24153-3111
Phone (540) 375-3937

Other identifiers 2

IdentifierTypeStateIssuer
P00301111OtherVARAILROAD MEDICARE
186600OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060316000570 VA Practitioner - Optometry 1456368505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1851 W Main St
Salem, VA 24153-3111
Phone (540) 375-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tim Jessee, Optometry Inc Optometrist CurrentSince Jan 1, 2005 Accepting new patients

Locations

313 Thacker Ave
Covington, VA 24426
Phone (540) 309-7431

1851 W Main St
Salem, VA 24153
Phone (540) 375-2624

Organizations & group practices 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225143639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533111",
            "telephone_number": "540-375-3937",
            "fax_number": "540-387-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533111",
            "telephone_number": "540-375-3937",
            "fax_number": "540-387-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEE",
        "first_name": "TIMOTHY",
        "middle_name": "GARLAND",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00301111",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "186600",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.