Individual provider Active NPI

Joshua Oliver, OD

  • Optometrist
  • Cookeville, TN
National Provider Identifier
1649848235
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD3686 Issued in TN
Practice address
999 Guardian Way
Cookeville, TN 38501-1722
Phone
(931) 650-4100
Fax
(931) 650-4101
NPI assigned
Jun 11, 2021
Last updated
Jun 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003018 VA
Optometrist 152W00000X OD3686 TN Primary

Addresses

Primary practice location

999 Guardian Way
Cookeville, TN 38501-1722

Mailing address

999 Guardian Way
Cookeville, TN 38501-1722
Phone (931) 650-4100

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
I20220518001204 TN Practitioner - Optometry 5496132144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Centers of Tennessee, LLCGroup PAC ID 1355379256, 18 clinicians

Practice addresses (Care Compare)

999 Guardian Way
Cookeville, TN 38506-0680
Phone (931) 650-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD3686TNMDOptometrist
0618003018VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of Tennessee, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients
Eye Centers of Tennessee, LLC Optometrist Current Accepting new patients
Eye Centers of Tennessee, LLC Optometrist CurrentSince Jul 1, 2022 Accepting new patients

Locations

999 Guardian Way
Cookeville, TN 38501
Phone (931) 650-4100

15 Iris Ln
Crossville, TN 38555
Phone (931) 456-2728

220 N Chancery St
McMinnville, TN 37110
Phone (931) 473-2487

3302 Main St
Pikeville, TN 37367
Phone (423) 556-0808

Interoperability endpoints

  • Direct secure messaging: joliver@ecotn.intellechartdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1649848235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 GUARDIAN WAY",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011722",
            "telephone_number": "931-650-4100",
            "fax_number": "931-650-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 GUARDIAN WAY",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011722",
            "telephone_number": "931-650-4100",
            "fax_number": "931-650-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003018",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD3686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.