Individual provider Active NPI

Carla Leslie Jones, O.D.

  • Optometrist
  • Clarksville, TN
National Provider Identifier
1770626947
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1681 Issued in TN
Practice address
1680 Fort Campbell Blvd
Clarksville, TN 37042-3537
Phone
(931) 645-5851
Fax
(931) 645-6917
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1681 TN Primary
Optometrist 152W00000X 1656 KY

Addresses

Primary practice location

1680 Fort Campbell Blvd
Clarksville, TN 37042-3537

Mailing address

4975 Highway 49
Tennessee Ridge, TN 37178-6033
Phone (931) 827-9137

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
I20120220000371 TN Practitioner - Optometry 9830357037 Practice locations: Clarksville, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1680 Fort Campbell Blvd
Clarksville, TN 37042-3537
Phone (931) 645-5851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1656KYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carla L. Jones O.D Optometrist PastSince Jun 10, 1996 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770626947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4975 HIGHWAY 49",
            "city": "TENNESSEE RIDGE",
            "state": "TN",
            "postal_code": "371786033",
            "telephone_number": "931-827-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 FORT CAMPBELL BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370423537",
            "telephone_number": "931-645-5851",
            "fax_number": "931-645-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CARLA",
        "middle_name": "LESLIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1681",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.