Individual provider Active NPI

Thomas E Jones, OD

  • Optometrist
  • Nixa, MO
National Provider Identifier
1275545659
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02977 Issued in MO
Practice address
940 W Mount Vernon St
Suite 120
Nixa, MO 65714-9609
Phone
(417) 724-5335
Fax
(417) 724-5333
NPI assigned
Aug 13, 2006
Last updated
Jan 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02977 MO Primary

Addresses

Primary practice location

940 W Mount Vernon St
Suite 120
Nixa, MO 65714-9609

Mailing address

940 W Mount Vernon St
Suite 120
Nixa, MO 65714-9609
Phone (417) 724-5335

Other identifiers 2

IdentifierTypeStateIssuer
316675719MedicaidMO
P00653956OtherRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040513000815 MO Practitioner - Optometry 1759371669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

940 W Mount Vernon St
120 MC Eye Spec Optometry Nixa
Nixa, MO 65714-9614
Phone (417) 724-5335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Optometrist CurrentSince Mar 28, 2008 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 28, 2008 Accepting new patients
Mercy Clinic Springfield Communities Optometrist Past Accepting new patients

Locations

940 W Mount Vernon St
Ste 120
Nixa, MO 65714
Phone (417) 724-5335

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: tjones2959@directb.mercy.net

Organizations & group practices 3

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1275545659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 120",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149609",
            "telephone_number": "417-724-5335",
            "fax_number": "417-724-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 120",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149609",
            "telephone_number": "417-724-5335",
            "fax_number": "417-724-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316675719",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00653956",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nixa, MO

Sources for this page

Verify at the official NPI Registry.