NPIMap

Organization Active NPI

Tommy J. Ducklo, OD PC

  • Optometrist
  • Nashville, TN
National Provider Identifier
1578733481
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TOMMY J. DUCKLO, OD PC
Practice address
2114 Elliston PL
Nashville, TN 37203-5238
Phone
(615) 329-0000
Fax
(615) 327-2431
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Tommy J. Ducklo, OD
Title
President
Phone
(615) 329-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2114 Elliston PL
Nashville, TN 37203-5238

Mailing address

2114 Elliston PL
Nashville, TN 37203-5238
Phone (615) 329-0000

Other identifiers 1

IdentifierTypeStateIssuer
3942134MedicaidTN

National Provider Directory

National Provider Directory

Locations

2114 Elliston Pl
Nashville, TN 37203
Phone (615) 329-0000

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1578733481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 ELLISTON PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035238",
            "telephone_number": "615-329-0000",
            "fax_number": "615-327-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 ELLISTON PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035238",
            "telephone_number": "615-329-0000",
            "fax_number": "615-327-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMMY J. DUCKLO, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "DUCKLO",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-329-0000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3942134",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.