Individual provider Active NPI

Jennifer K Mallory, O.D.

  • Optometrist
  • Columbia, TN
National Provider Identifier
1285895946
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT2798 Issued in TN
Practice address
403 N Garden St
Columbia, TN 38401-2903
Phone
(931) 380-2020
NPI assigned
Jun 24, 2008
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT2798 TN Primary

Addresses

Primary practice location

403 N Garden St
Columbia, TN 38401-2903

Mailing address

4886 Port Royal Rd Ste 150
Spring Hill, TN 37174-8807
Phone (931) 489-6118

Other practice location 1

4886 Port Royal Rd Ste 150
Spring Hill, TN 37174-8807
Phone (931) 489-6118

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
I20080919000136 TN Practitioner - Optometry 2769559525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Care PLLCGroup PAC ID 7810057239, 2 clinicians

Practice addresses (Care Compare)

403 N Garden
Columbia, TN 38401-2903
Phone (931) 380-2020

403 N Garden St
Columbia, TN 38401-2903

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODT2798TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Price Eye Associates, PLLC Optometrist CurrentSince Aug 25, 2024 Accepting new patients
Family Eye Care PLLC Optometrist CurrentSince May 5, 2025 Accepting new patients
C&V Opticals,Inc. PastSince Feb 1, 2021 Accepting new patients
Family Eyecare PLLC Optometrist Past Accepting new patients

Locations

403 N Garden St
Columbia, TN 38401
Phone (931) 380-2020

4886 Port Royal Rd
Ste 150
Spring Hill, TN 37174
Phone (931) 489-6118

Organizations & group practices 4

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1285895946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4886 PORT ROYAL RD STE 150",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371748807",
            "telephone_number": "931-489-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N GARDEN ST",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384012903",
            "telephone_number": "931-380-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4886 Port Royal Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Spring Hill",
            "state": "TN",
            "postal_code": "371748807",
            "country_code": "US",
            "telephone_number": "931-489-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT2798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.