NPIMap

Organization Active NPI

James L Ducklo OD

  • Optometrist
  • Antioch, TN
National Provider Identifier
1285786145
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT1233 Issued in TN
Legal business name
JAMES L DUCKLO OD
Practice address
5252 Hickory Hollow Pkwy
Suite 1133
Antioch, TN 37013-3005
Phone
(615) 731-6230
Fax
(615) 731-6538
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Authorized official

Name
Dawn Williams
Title
Office Manager
Phone
(615) 731-6230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ODT1233 TN Primary

Addresses

Primary practice location

5252 Hickory Hollow Pkwy
Suite 1133
Antioch, TN 37013-3005

Mailing address

5252 Hickory Hollow Pkwy
Suite 1133
Antioch, TN 37013-3005
Phone (615) 731-6230

Other identifiers 3

IdentifierTypeStateIssuer
TN1233OtherTNEYEMED
5697119OtherTNFIRST HEALTH
0118062OtherTNBLUE CROSS BLUE SHIELD

Other names 1

  • James L Ducklo Od and Associates Doing business as

National Provider Directory

National Provider Directory

Locations

5252 Hickory Hollow Pkwy
Ste 1133
Antioch, TN 37013
Phone (615) 731-6230

401 S Mount Juliet Rd
#36
Mount Juliet, TN 37122

401 S Mount Juliet Rd
Ste 36
Mount Juliet, TN 37122

2126 Abbott Martin Rd
Ste 190
Nashville, TN 37215
Phone (615) 269-3500

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1285786145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 HICKORY HOLLOW PKWY",
            "address_2": "SUITE 1133",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133005",
            "telephone_number": "615-731-6230",
            "fax_number": "615-731-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 HICKORY HOLLOW PKWY",
            "address_2": "SUITE 1133",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133005",
            "telephone_number": "615-731-6230",
            "fax_number": "615-731-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES L DUCKLO OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-731-6230"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT1233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "TN1233",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5697119",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0118062",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James L Ducklo Od and Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.