Individual provider Active NPI

Joseph Tyler Trent, OD

  • Optometrist
  • Rogersville, TN
National Provider Identifier
1265006373
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3694 Issued in TN
Practice address
107 E Main St
Rogersville, TN 37857-3309
Phone
(423) 272-2020
NPI assigned
May 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 3694 TN Primary

Addresses

Primary practice location

107 E Main St
Rogersville, TN 37857-3309

Mailing address

144 Elizabeth St
Bean Station, TN 37708-4319
Phone (423) 736-3572

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210818003134 TN Practitioner - Optometry 0547665267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 E Main St
Rogersville, TN 37857-3309
Phone (423) 272-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3694TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rogersville Vision Clinic,PLLC Optometrist CurrentSince Jun 30, 2021 Accepting new patients
Rogersville Vision Clinic, PLLC Optometrist PastSince May 16, 2021 Accepting new patients

Locations

2020 Chapman Hwy
Ste 1
Knoxville, TN 37920
Phone (865) 573-2443

107 E Main St
Rogersville, TN 37857
Phone (423) 272-2020

Interoperability endpoints

  • Direct secure messaging: joseph.trent@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1265006373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 ELIZABETH ST",
            "city": "BEAN STATION",
            "state": "TN",
            "postal_code": "377084319",
            "telephone_number": "423-736-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E MAIN ST",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378573309",
            "telephone_number": "423-272-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "JOSEPH",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "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": "TN",
            "license": "3694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

Verify at the official NPI Registry.