Individual provider Active NPI

Jason C. Witters, O.D.

  • Optometrist
  • Nolensville, TN
National Provider Identifier
1740239615
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3662 Issued in TN
Practice address
7171 Nolensville Rd Ste 104
Nolensville, TN 37135-6101
Phone
(615) 815-1632
Fax
(615) 534-2178
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3662 TN Primary

Addresses

Primary practice location

7171 Nolensville Rd Ste 104
Nolensville, TN 37135-6101

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
08148991MedicaidCO

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
I20211024000024 TN Practitioner - Optometry 3375577539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7171 Nolensville Rd
Suite 104
Nolensville, TN 37135-6101
Phone (615) 815-1632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3662TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Jul 20, 2021 Accepting new patients
Myeyedr Optometry of Tennessee LLC Optometrist CurrentSince Jul 20, 2021 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist Current Accepting new patients

Locations

629 Market St
Ste 115
Chattanooga, TN 37402
Phone (423) 265-4306

7091 Old Harding Pike
Ste 105
Nashville, TN 37221
Phone (615) 662-2800

7171 Nolensville Rd
Ste 104
Nolensville, TN 37135

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1740239615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "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": "7171 NOLENSVILLE RD STE 104",
            "city": "NOLENSVILLE",
            "state": "TN",
            "postal_code": "371356101",
            "telephone_number": "615-815-1632",
            "fax_number": "615-534-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTERS",
        "first_name": "JASON",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2023-03-07",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08148991",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nolensville, TN

Sources for this page

Verify at the official NPI Registry.