Individual provider Active NPI

Jason Walston, OD

  • Optometrist
  • Hendersonville, TN
National Provider Identifier
1750684122
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0000002970 Issued in TN
Practice address
386 W Main St
Suite 104
Hendersonville, TN 37075-3349
Phone
(615) 338-3602
NPI assigned
Dec 7, 2010
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0000002970 TN Primary

Addresses

Primary practice location

386 W Main St
Suite 104
Hendersonville, TN 37075-3349

Mailing address

386 W Main St
Suite 104
Hendersonville, TN 37075-3349
Phone (615) 338-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170726002963 WA Practitioner - Optometry 8123290624 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silverdale Eye Care Center IncGroup PAC ID 2062309313, 4 clinicians

Practice addresses (Care Compare)

101 Milton Way
Milton, WA 98354-8800
Phone (253) 922-0333

3647 NW Byron St
Suite 100
Silverdale, WA 98383-7680
Phone (360) 692-6115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000002970TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Port Orchard Eyecare Centers Inc, PS Optometrist CurrentSince Jun 15, 2017 Accepting new patients
Auburn Eyecare Center, LLC Optometrist CurrentSince Jun 15, 2017 Accepting new patients
Milton Eyecare Center, LLC Optometrist CurrentSince Oct 21, 2019 Accepting new patients
Silverdale Eyecare Center Inc Optometrist CurrentSince Jun 15, 2017 Accepting new patients

Locations

1105 Harvey Rd NE
Auburn, WA 98002
Phone (253) 833-5000

101 Milton Way
Milton, WA 98354
Phone (253) 922-0333

2914 Mitchell Rd SE
Port Orchard, WA 98366
Phone (360) 784-2020

3647 NW Byron St
Ste 100
Silverdale, WA 98383
Phone (360) 692-6115

Organizations & group practices 4

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": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1750684122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 W MAIN ST",
            "address_2": "SUITE 104",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753349",
            "telephone_number": "615-338-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 W MAIN ST",
            "address_2": "SUITE 104",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753349",
            "telephone_number": "615-338-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSTON",
        "first_name": "JASON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "0000002970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.