Jaelyn Deberry, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0000003546 Issued in TN

Practice address

2817 Bartlett Blvd
Bartlett, TN 38134-4529

Phone

(901) 371-0770

Fax

(901) 371-9892

NPI assigned

Sep 14, 2019

Last updated

Jun 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Infocus Eyecare, PLLC

  • Optometrist
  • Cordova, TN
  • NPI 1902145063
  Medicare reassignment NPD
• Myeyedr Optometry of Tennessee, LLC

  dba MyEyeDr.

  • Optometrist
  • Chattanooga, TN
  • NPI 1619481587
  Medicare reassignment NPD
• Myeyedr Optometry of Tennessee, LLC

  • Optometrist
  • Mount Juliet, TN
  • NPI 1588516918
  NPD
• Myeyedr Optometry of Tennessee, LLC

  dba MyEyeDr.

  • Optometrist
  • Memphis, TN
  • NPI 1720547144
  NPD

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1295385912",
    "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",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 BARTLETT BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344529",
            "telephone_number": "901-371-0770",
            "fax_number": "901-371-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERRY",
        "first_name": "JAELYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "0000003546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anika Smith Dawson, LMSW
• Denese D Day
• James Dylan Day, DDS
• Mary L Dean Turner, PHMNP
• Katherine Donovan Dean, C-PNP
• Debras House of Care
• Dedicated Care Home Health LLC
• Aaron Michael Delay, LPC, MHSP
• Delta Transportation Services
• Matthew Demarco, PHARMD

• Optometrist in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.