Prodigy Trust Company

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

ODT000859 Issued in TN

Legal business name

PRODIGY TRUST COMPANY

Practice address

7640 Highway 70 S
Ste 204
Nashville, TN 37221-1758

Phone

(615) 662-2800

Fax

(615) 662-0411

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Carr Jessup, ODNPI 1104982701

Title

Manager

Phone

(615) 662-2800

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Carr Jessup, O.D.

  • Optometrist
  • Nashville, TN
  • NPI 1104982701

  Corneal and Contact Management

  NPD (past) Authorized official

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1497915920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 HIGHWAY 70 S",
            "address_2": "STE 204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372211758",
            "telephone_number": "615-662-2800",
            "fax_number": "615-662-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 HIGHWAY 70 S",
            "address_2": "STE 204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372211758",
            "telephone_number": "615-662-2800",
            "fax_number": "615-662-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY TRUST COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "JESSUP",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CARR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-662-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "ODT000859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0047504",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC PIN",
            "identifier": "0792070001",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Suzanne Proctor, NP
• Ashford Amanda Proctor, RN
• Ashley Proctor
• Hannah Proctor, CNM
• John H. Proctor, M.D.
• Alysha M Profeta
• Proficient Transport Services LLC
• Laurie Profitt, RN
• Progress Inc
• Progress Inc.

• Corneal and Contact Management Optometrist in Nashville, TN
• Providers in Nashville, TN by specialty
• Corneal and Contact Management Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.