Active NPI
John J Maria, O.D.
- Optometrist
- Dover, TN
National Provider Identifier
1477586675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TN1471
- Practice address
- 1306 Donelson Pkwy
Dover, TN 37058-3753 - Phone
- (931) 232-5118
- Fax
- (931) 232-0581
- NPI assigned
- Jul 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TN1471 | TN | Primary |
Addresses
Primary practice location
1306 Donelson Pkwy
Dover, TN 37058-3753
Mailing address
1306 Donelson Pkwy
Dover, TN 37058-3753
Phone (931) 232-5118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TN1471 | Other | TN | STATE LICENSE NUMBER |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111013000492 | TN | Practitioner - Optometry | 4789679762 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1471 | TN | MD | Professional Counselor |
| TN1471 | TN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hermitage Eye Care PLLC | Optometrist | Current | Accepting new patients |
| Clarksville Eye Clinic LLC | Optometrist | Past | Accepting new patients |
| Hermitage Eye Care PLLC | Optometrist | Past | Accepting new patients |
Locations
782 Old Hickory Blvd
Ste 204
Brentwood, TN 37027
Phone (615) 373-9992
1306 Donelson Pkwy
Dover, TN 37058
Phone (631) 232-5118
Interoperability endpoints
- jmaria@dovereye.qrsdm.com
Organizations & group practices 3
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.
-
- Optometrist
- Hermitage, TN
- NPI 1275943052
-
- Optometrist
- Clarksville, TN
- NPI 1649474263
-
- Optometrist
- Brentwood, TN
- NPI 1689479909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477586675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 DONELSON PKWY",
"city": "DOVER",
"state": "TN",
"postal_code": "370583753",
"telephone_number": "931-232-5118",
"fax_number": "931-232-0581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 DONELSON PKWY",
"city": "DOVER",
"state": "TN",
"postal_code": "370583753",
"telephone_number": "931-232-5118",
"fax_number": "931-232-0581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIA",
"first_name": "JOHN",
"middle_name": "J",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "TN1471",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "TN1471",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dover, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.