Individual provider Active NPI

John J Maria, O.D.

  • Optometrist
  • Dover, TN
National Provider Identifier
1477586675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN1471 Issued in TN
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
TN1471OtherTNSTATE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000492 TN Practitioner - Optometry 4789679762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1471TNMDProfessional Counselor
TN1471TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hermitage Eye Care PLLC Optometrist CurrentSince Jun 22, 2021 Accepting new patients
Clarksville Eye Clinic LLC Optometrist Past Accepting new patients
Hermitage Eye Care PLLC Optometrist PastSince Feb 23, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.