Individual provider Active NPI

James Dylan Bondurant, O.D.

  • Optometrist
  • Union City, TN
National Provider Identifier
1760646277
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2834 Issued in TN
Practice address
622 E Reelfoot Ave
Union City, TN 38261-5739
Phone
(731) 885-0541
NPI assigned
Jul 14, 2008
Last updated
Jul 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2834 TN Primary

Addresses

Primary practice location

622 E Reelfoot Ave
Union City, TN 38261-5739

Mailing address

622 E Reelfoot Ave
Union City, TN 38261-5739
Phone (731) 885-0541

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
I20081106000785 TN Practitioner - Optometry 9032278932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS. Jordan and Bondurant PLLCGroup PAC ID 8022177997, 2 clinicians

Practice addresses (Care Compare)

622 E Reelfoot Ave
Union City, TN 38261-5739
Phone (731) 885-0541

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Jordan & Bondurant PLLC Optometrist CurrentSince Sep 1, 2008 Accepting new patients

Locations

622 E Reelfoot Ave
Union City, TN 38261
Phone (731) 885-0541

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1760646277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 E REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615739",
            "telephone_number": "731-885-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 E REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615739",
            "telephone_number": "731-885-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDURANT",
        "first_name": "JAMES",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.