Jackson Tyler Clark

Primary specialty

OptometristTaxonomy code 152W00000X

License

18004592A Issued in IN

Practice address

6985 W 38TH St Ste 100
Indianapolis, IN 46254-3918

Phone

(317) 243-0028

NPI assigned

May 21, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Indiana University - School of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Indiana LLC 82 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424

  IN, Optometrist

  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1093201485
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1356900195
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Terre Haute, IN
  • NPI 1588150908
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Valparaiso, IN
  • NPI 1669931846
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Fishers, IN
  • NPI 1699261024
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Anderson, IN
  • NPI 1710473194
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Fort Wayne, IN
  • NPI 1962998393
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Michigan City, IN
  • NPI 1982190328
  Care Compare group
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1679314686
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1245022540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6985 W 38TH ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462543918",
            "telephone_number": "317-243-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JACKSON",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004592A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• G Gregory Clark, M.D.
• Georgia Ellen Clark, OD
• Gregory S Clark, PA-C
• Haleigh Clark
• Holly Marie Clark, D.D.S.
• Jainie Clark, RN, NP-C
• Janet C Clark, D.D.S.
• Jason Clark, PTA
• Jesse N Clark, DO
• Jessica Ann Clark, M.A., CCC-SLP

• All providers in Indianapolis, IN
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.