Individual provider Active NPI

Jonathan Shelton, O.D.

  • Optometrist
  • Lexington, TN
National Provider Identifier
1649417726
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2904 Issued in TN
Practice address
369 W Church St
Lexington, TN 38351-2096
Phone
(731) 968-5225
Fax
(731) 967-3291
NPI assigned
Jan 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2904 TN Primary

Addresses

Primary practice location

369 W Church St
Lexington, TN 38351-2096

Mailing address

369 W Church St
Lexington, TN 38351-2096
Phone (731) 968-5225

Other identifiers 2

IdentifierTypeStateIssuer
1515311MedicaidTN
4235338OtherTNBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090818000031 TN Practitioner - Optometry 2365596996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

185 Boswell St
Lexington, TN 38351-1597
Phone (731) 968-5225

369 W Church St
Lexington, TN 38351-2096
Phone (731) 968-5225

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2904TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Family Eyecare, Inc. Optometrist CurrentSince Aug 18, 2009 Accepting new patients

Locations

185 Boswell St
Lexington, TN 38351
Phone (731) 968-1860

369 W Church St
Lexington, TN 38351
Phone (731) 249-5101

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1649417726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 W CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383512096",
            "telephone_number": "731-968-5225",
            "fax_number": "731-967-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 W CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383512096",
            "telephone_number": "731-968-5225",
            "fax_number": "731-967-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JONATHAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-12",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515311",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4235338",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, TN

Sources for this page

Verify at the official NPI Registry.