Individual provider Active NPI

Wayne Eric Jones, O.D.

  • Optometrist
  • Tyler, TX
National Provider Identifier
1528030095
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9135 Issued in TX
Practice address
1327 Troup Hwy
Tyler, TX 75701-4443
Phone
(903) 606-4733
Fax
(903) 606-5853
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008905 IL
Optometrist 152W00000X 9135 TX Primary

Addresses

Primary practice location

1327 Troup Hwy
Tyler, TX 75701-4443

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other practice location 1

314 Fountains Pkwy
Suite D
Fairview Heights, IL 62208-2165
Phone (618) 622-3939

Other identifiers 1

IdentifierTypeStateIssuer
046008905 1MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170303000588 TX Practitioner - Optometry 0749251981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of North Texas HSC, College of Osteopathic Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1327 Troup Hwy
Tyler, TX 75701-4443
Phone (903) 510-8764

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9135TXMDProfessional Counselor
046008905ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 23, 2017 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 23, 2017 Accepting new patients
Trinity Clinic Past Accepting new patients
JFJ Eyecare LTD Optometrist Past Accepting new patients
JFJ Eyecare, LTD Optometrist Past Accepting new patients
Southern Illinois Eyecare PLLC Optometrist Past Accepting new patients
Illinois Retina Surgery LTD Past Accepting new patients

Locations

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764

Interoperability endpoints

  • Direct secure messaging: ejones140266@christushealth.direct-ci.net

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528030095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014443",
            "telephone_number": "903-606-4733",
            "fax_number": "903-606-5853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 Fountains Pkwy",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622082165",
            "country_code": "US",
            "telephone_number": "618-622-3939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "WAYNE",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008905",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008905 1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.