Individual provider Active NPI

John Anthony Stacy Jr., O.D.

  • Optometrist
  • North Chesterfield, VA
National Provider Identifier
1710310875
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002268 Issued in VA
Practice address
601 N Courthouse Rd
North Chesterfield, VA 23236-4062
Phone
(804) 858-2020
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002268 VA Primary

Addresses

Primary practice location

601 N Courthouse Rd
North Chesterfield, VA 23236-4062

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140127000783 VA Practitioner - Optometry 6406085216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oatman Nilsen and Associates Optometrists LTDGroup PAC ID 5496840142, 9 clinicians

Practice addresses (Care Compare)

44727 Brimfield Dr
Ashburn, VA 20147-5920
Phone (571) 385-4600

601 N Courthouse Rd
North Chesterfield, VA 23236-4062
Phone (804) 858-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002268VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Sep 1, 2015 Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Sep 1, 2015 Accepting new patients
Oatman Nilsen & Associates Optometrists LTD Optometrist CurrentSince Oct 17, 2016 Accepting new patients
Ballston Optometry, LLC Optometrist Past Accepting new patients

Locations

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

601 N Courthouse Rd
Ste 2
North Chesterfield, VA 23236
Phone (804) 858-2020

601 N Courthouse Rd
North Chesterfield, VA 23236
Phone (804) 858-2020

165 Spicers Mill Rd
Orange, VA 22960
Phone (276) 762-2331

1660 Anderson Hwy
Powhatan, VA 23139
Phone (804) 897-3334

3524 W Cary St
Richmond, VA 23221
Phone (804) 750-7113

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1710310875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N COURTHOUSE RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364062",
            "telephone_number": "804-858-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.