Edwin Gwin Anderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT643 Issued in TN

Practice address

113 E Locust St
Dresden, TN 38225-1440

Phone

(731) 364-2150

Fax

(731) 364-5157

NPI assigned

Apr 27, 2006

Last updated

Oct 23, 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 1

Addresses

Other identifiers 1

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, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jessup Mobile Opt TN LLCGroup PAC ID 3476898073, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.06 of 100Reported as group

Quality

79.74

Promoting interoperability

84

Improvement activities

40

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.

• Jessup Mobile Opt TN LLC

  • Optometrist
  • Nashville, TN
  • NPI 1740763325
  Medicare reassignment Care Compare group NPD
• Optometric Center Professional Corporation

  dba Optometric Center PC

  • Optometrist
  • Dresden, TN
  • NPI 1316012099
  Authorized official Same address or phone
• McKenzie Medical Center PC

  dba Hometown Health Clinic

  • Rural Health Clinic/Center
  • McKenzie, TN
  • NPI 1477516953

  Optometrist

  NPD

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1609833227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31",
            "city": "DRESDEN",
            "state": "TN",
            "postal_code": "382250031",
            "telephone_number": "731-364-2150",
            "fax_number": "731-364-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E LOCUST ST",
            "city": "DRESDEN",
            "state": "TN",
            "postal_code": "382251440",
            "telephone_number": "731-364-2150",
            "fax_number": "731-364-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EDWIN",
        "middle_name": "GWIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "ODT643",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.