Individual provider Active NPI

Jeremy Hutchinson, OD

  • Optometrist
  • Fort Bragg, NC
National Provider Identifier
1396504965
Registry record updated May 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3264 Issued in OK
Practice address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-7017
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4061 CO
Optometrist 152W00000X 3264 OK Primary

Addresses

Primary practice location

2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-7017

Mailing address

2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001
Phone (910) 907-8922

Other practice location 1

1001 N Grand Ave
Tahlequah, OK 74464-7017
Phone (918) 444-4031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3264OKMDRegistered Dietitian
4061COMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748044800000",
    "number": "1396504965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107017",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Tahlequah",
            "state": "OK",
            "postal_code": "744647017",
            "country_code": "US",
            "telephone_number": "918-444-4031",
            "fax_number": "918-458-9603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "JEREMY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-05-24",
        "certification_date": "2025-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "4061",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2025; 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.