Jerry Randall Nutt Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2570 Issued in AR

Practice address

515 Cash Rd SW
Camden, AR 71701-3706

Phone

(870) 836-2525

Fax

(870) 836-7252

NPI assigned

Sep 28, 2006

Last updated

May 10, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Optometry

Education

Southern College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Care Center, Inc.Group PAC ID 3678617115, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Eye Care Center, Inc.

  • Optometrist
  • Camden, AR
  • NPI 1003145319
  Medicare reassignment Care Compare group NPD Authorized official
• Family Eyecare Center Inc

  • Optometrist
  • Fordyce, AR
  • NPI 1962836585
  NPD Authorized official
• George M Dunn Jr OD PA

  • Health Maintenance Organization
  • Stuttgart, AR
  • NPI 1912129859
  NPD (past)
• W. Brent Hall, O.D. P.a.

  • Optometrist
  • Pine Bluff, AR
  • NPI 1295760767
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1871685065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CASH RD SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013706",
            "telephone_number": "870-836-2525",
            "fax_number": "870-836-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CASH RD SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013706",
            "telephone_number": "870-836-2525",
            "fax_number": "870-836-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "JERRY",
        "middle_name": "RANDALL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BCBS",
            "identifier": "49958",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BCBS MEDIPAK",
            "identifier": "49958",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE ADVANTAGE",
            "identifier": "49958",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIPAK ADVANTAGE",
            "identifier": "49958",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARD/AR BCBS",
            "identifier": "49958",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180852722",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "49958",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neat RX Inc (M&S Clinic Pharmacy)
• Neat RX, Inc (Camden Drug)
• Neat RX, Inc (Camden Drug)
• Need to Know Testing, LLC
• Next Page Family Support Services
• Adam O'Dell
• Ocnc, Inc. (Silver Oaks Health and Rehabilitation)
• Odyssey Healthcare Operating a, LP (Kindred Hospice I)
• Marissa Olivarez-Baldwin, LAC
• Ouachita County Medical Center

• Optometrist in Camden, AR
• Providers in Camden, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.