Tara Leigh Jordan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002683 Issued in GA

Practice address

3303A Glynn Ave
Brunswick, GA 31520-4406

Phone

(912) 466-9500

Fax

(912) 466-9922

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tara Leigh Engstrom Former name

Medicare fee-for-service enrollment

Enrolled in SC, GA2 enrollments

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 2

Specialty

Optometry

Education

Nova Southeastern Univ College of Dental Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seaside Ophthalmology IncGroup PAC ID 3375571995, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Seaside Ophthalmology, Inc

  • Ophthalmology Physician
  • Brunswick, GA
  • NPI 1427113554

  Optometrist

  Medicare reassignment Care Compare group NPD
• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321

  Optometrist

  Medicare reassignment NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD
• Kandallu R Ramesh, MD, PC

  • Otolaryngology Physician
  • Waycross, GA
  • NPI 1699044040
  NPD (past)
• Dr. Michael a. Campbell

  • Clinic/Center
  • Hilton Head Island, SC
  • NPI 1629276605
  NPD (past)
• Optical Solutions

  • Eyewear Supplier
  • Hilton Head Island, SC
  • NPI 1649319930
  NPD (past)

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1437446432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303A GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204406",
            "telephone_number": "912-466-9500",
            "fax_number": "912-466-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303A GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204406",
            "telephone_number": "912-466-9500",
            "fax_number": "912-466-9922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Darling Ave",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015219",
            "country_code": "US",
            "telephone_number": "912-584-0047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TARA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "OPT002683",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "ENGSTROM",
            "middle_name": "LEIGH",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Kenneth Jones, AA-C
• Mitchell Taylor Jones, M.D.
• Steven Jones, CRNA
• Anthony G. Jongejan, MMP, LMT
• Bobby Jean Jopling, M. ED., CCC-SLP
• Amanda Grounds Joseph, MD
• Jason Michael Joseph, MD
• Natasha Jovin, L-314482
• Joyful Home Care, LLC
• Juanita Y Lott MD PC

• Optometrist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.