Individual provider Active NPI

Rachelle Moriah Jackson, O.D.

  • Vision Therapy Optometrist
  • Murfreesboro, TN
National Provider Identifier
1710410717
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
3351 Issued in TN
Practice address
4167 Franklin Rd Ste 2a
Murfreesboro, TN 37128-4257
Phone
(615) 295-8585
NPI assigned
Apr 6, 2017
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 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 TN3351 TN
Vision Therapy Optometrist 152WV0400X 3351 TN Primary

Addresses

Primary practice location

4167 Franklin Rd Ste 2a
Murfreesboro, TN 37128-4257

Mailing address

4167 Franklin Rd Ste 2a
Murfreesboro, TN 37128-4257
Phone (615) 295-8585

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
I20170816002397 TN Practitioner - Optometry 4183996762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4167 Franklin Rd
Suite 2a
Murfreesboro, TN 37128-4257
Phone (615) 295-8585

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TN3351TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Eyecare, PLLC Optometrist CurrentSince Sep 16, 2019 Accepting new patients

Locations

4167 Franklin Rd
Ste A2
Murfreesboro, TN 37128
Phone (615) 295-8585

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, 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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1710410717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4167 FRANKLIN RD STE 2A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284257",
            "telephone_number": "615-295-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4167 FRANKLIN RD STE 2A",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371284257",
            "telephone_number": "615-295-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RACHELLE",
        "middle_name": "MORIAH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN3351",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "3351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.