Individual provider Active NPI

Elizabeth Gay Nordtvedt, O.D.

  • Optometrist
  • Jackson, TN
National Provider Identifier
1861655979
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2800 Issued in TN
Practice address
112 Stonebridge Blvd
Jackson, TN 38305-2038
Phone
(731) 664-1994
NPI assigned
Jul 8, 2008
Last updated
Sep 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2800 TN Primary

Addresses

Primary practice location

112 Stonebridge Blvd
Jackson, TN 38305-2038

Mailing address

18 Millview CV
Jackson, TN 38305-8593

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
I20110413000422 TN Practitioner - Optometry 3971787177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Eye Associates PCGroup PAC ID 4789780495, 8 clinicians

Practice addresses (Care Compare)

112 Stonebridge Blvd
Jackson, TN 38305-2038
Phone (731) 664-1994

Merit-based Incentive Payment System (MIPS)

Final score
88.59 of 100Reported as group
Quality
92.12
Improvement activities
40
Cost
72.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Eye Associates PC Optometrist CurrentSince Mar 15, 2011 Accepting new patients
Rogers Eye Center PC Optometrist PastSince Aug 1, 2019 Accepting new patients

Locations

112 Stonebridge Blvd
Jackson, TN 38305
Phone (800) 945-1994

202 W Church St
Lexington, TN 38351
Phone (731) 450-2663

285 Main St
Savannah, TN 38372
Phone (731) 925-6225

Interoperability endpoints

  • Direct secure messaging: drnordtvedt@hugheseye.direct.eyemdemr.com

Organizations & group practices 2

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315180800000",
    "number": "1861655979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MILLVIEW CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052038",
            "telephone_number": "731-664-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDTVEDT",
        "first_name": "ELIZABETH",
        "middle_name": "GAY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.