Stan Jordan Whitley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

909T Issued in TN

Practice address

312 South Main St
Covington, TN 38019

Phone

(901) 476-8614

Fax

(901) 475-1921

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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, 1983

Medicare assignment

May accept Medicare assignment

Group practices

Bierman Whitley and Hughes PTRS 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Bierman Whitley & Hughes PTRS

  • Optometrist
  • Covington, TN
  • NPI 1992921639
  Medicare reassignment Care Compare group NPD
• Bierman Whitley & Hughes PTRS

  • Optometrist
  • Munford, TN
  • NPI 1639360043
  NPD

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568570232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 SOUTH MAIN ST",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "38019",
            "telephone_number": "901-476-8614",
            "fax_number": "901-475-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 SOUTH MAIN ST",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "38019",
            "telephone_number": "901-476-8614",
            "fax_number": "901-475-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "STAN",
        "middle_name": "JORDAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "909T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2002815",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941840",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie A Wetzel
• Becky J White, RN
• Lloyette White
• Jeffrey L Whitley, DDS
• Olivia Whitley, OTR/L
• Patsy Whitson
• Edwin Kendall Williams Jr., D.PH.
• Kerry Kelley Williams, OTR/L
• Rosalind T Williamson
• Tristen Gabrielle Willis, COTA

• All providers in Covington, TN
• Optometrist in Tennessee

• 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.

Verify at the official NPI Registry.