Brandon W Walley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2811 Issued in TN

Practice address

358 New Byhalia Rd
Suite 3
Collierville, TN 38017-3743

Phone

(901) 853-8180

Fax

(901) 853-1421

NPI assigned

Jun 24, 2008

Last updated

Nov 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Collierville Vision Center PLLC

  • Optometrist
  • Collierville, TN
  • NPI 1760888549
  Medicare reassignment NPD Authorized official
• Walley Wellness PLLC

  • Optometrist
  • Collierville, TN
  • NPI 1730624370
  Authorized official Same address or phone
• Brandon Professional Eyecare Associates, Inc.

  • Optometrist
  • Brandon, MS
  • NPI 1477954352
  NPD (past)

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1508027277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 NEW BYHALIA RD",
            "address_2": "SUITE 3",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173743",
            "telephone_number": "901-853-8180",
            "fax_number": "901-853-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 NEW BYHALIA RD",
            "address_2": "SUITE 3",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173743",
            "telephone_number": "901-853-8180",
            "fax_number": "901-853-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEY",
        "first_name": "BRANDON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "805",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS LICENSE",
            "identifier": "805",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11861175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "2811",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nia Walker, RBT
• Tracy R Walker, CRNA
• Walter S Walker, D.C.
• Mark Alan Wallace, DC
• Walley Wellness PLLC
• Jessica Wang, DDS
• Earnicia Washington, D.C.
• Abby Watts
• Stacy Ladawn Wegner, PA-C
• Justin Christopher Welch, PHARMD

• Optometrist in Collierville, TN
• Providers in Collierville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.