Organization Active NPI

Tammy Holsclaw-Jones OD PLLC

  • Optometrist
  • Elizabethton, TN
National Provider Identifier
1407025968
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TAMMY HOLSCLAW-JONES OD PLLC
Practice address
210 Rogosin Dr.
Elizabethton, TN 37643
Phone
(423) 543-6868
Fax
(423) 543-4226
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Dr. Tammy L. Holsclaw-Jones
Title
Optometrist
Phone
(423) 543-6868

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X ODT0000001180 TN
Eyewear Supplier 332H00000X

Addresses

Primary practice location

210 Rogosin Dr.
Elizabethton, TN 37643

Mailing address

210 Rogosin Dr.
Elizabethton, TN 37643
Phone (423) 543-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230125000551 TN Part B Supplier - Clinic/Group Practice 9931316742 Receives reassigned benefits from 1 practitioner
Practice locations: Elizabethton, TN

National Provider Directory

National Provider Directory

Locations

210 Rogosin Dr
Elizabethton, TN 37643
Phone (423) 543-6868

Practitioners & affiliated clinicians

Practitioners 3

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": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1407025968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ROGOSIN DR.",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-543-6868",
            "fax_number": "423-543-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ROGOSIN DR.",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-543-6868",
            "fax_number": "423-543-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMMY HOLSCLAW-JONES OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "HOLSCLAW-JONES",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "423-543-6868",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TN",
            "license": "ODT0000001180",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.