Jeremy Allen Elmore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003454A Issued in IN

Practice address

735 Whitfield Dr
Columbus, IN 47201-2611

Phone

(812) 375-9439

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southside Eye Center, P.C.Group PAC ID 9638350515, 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.

• Southside Eye Center, P.C.

  • Optometrist
  • Greenwood, IN
  • NPI 1396054458
  Medicare reassignment Care Compare group NPD Authorized official
• Midwest Eye Consultants, P.C.

  • Ophthalmology Physician
  • Fort Wayne, IN
  • NPI 1912960535
  Medicare reassignment NPD
• Midwest Eye Consultants, PC

  • Optometrist
  • Danville, IN
  • NPI 1316686579
  NPD
• Midwest Eye Consultants, PC

  • Optometrist
  • Fort Wayne, IN
  • NPI 1548132715
  NPD

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699972968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 ECHO BEND ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421119",
            "telephone_number": "317-908-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 WHITFIELD DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472012611",
            "telephone_number": "812-375-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "JEREMY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003454A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Ann Eggers
• Nicole Louise Eldridge, LSW
• Briana Elkins, RBT
• Lori A Ellegood, MSW, LCSW
• Robert Neil Elliott, M.D.
• Elpers Eyecare Inc
• Emergency Physicians Inc of Columbus
• Rachel Emerton, PHARMD
• Richard Emerton
• Empowering Kids Speech Therapy, LLC

• Optometrist in Columbus, IN
• Providers in Columbus, IN by specialty
• Optometrist in Indiana

• 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.