Individual provider Active NPI

James David Gillispie, O.D.

  • Optometrist
  • Hermitage, TN
National Provider Identifier
1881747129
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTN1334 Issued in TN
Practice address
5528A Old Hickory Blvd
Hermitage, TN 37076-2576
Phone
(615) 885-2027
Fax
(615) 885-2037
NPI assigned
Jan 19, 2007
Last updated
Dec 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTN1334 TN Primary

Addresses

Primary practice location

5528A Old Hickory Blvd
Hermitage, TN 37076-2576

Mailing address

4130 Andrew Jackson Pkwy
Hermitage, TN 37076-2203
Phone (615) 885-2027

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
I20110316000018 TN Practitioner - Optometry 7911189790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gillispie Eye Care PLLCGroup PAC ID 6608176383, 2 clinicians

Practice addresses (Care Compare)

404 N Castle Heights Ave
Lebanon, TN 37087-1511
Phone (615) 449-0541

4130 Andrew Jackson Pkwy
Hermitage, TN 37076-2203
Phone (615) 885-2027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODTN1334TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gillispie Eye Care PLLC Optometrist CurrentSince Aug 24, 2015 Accepting new patients
James C. Loden, MD PC Past Accepting new patients
Nashville TN Ophthalmology ASC LLC Past Accepting new patients

Locations

4130 Andrew Jackson Pkwy
Hermitage, TN 37076
Phone (615) 885-2027

404 N Castle Heights Ave
Ste A
Lebanon, TN 37087
Phone (615) 449-0541

404 N Castle Heights Ave
Lebanon, TN 37087
Phone (615) 327-2001

Organizations & group practices 3

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1881747129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 ANDREW JACKSON PKWY",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762203",
            "telephone_number": "615-885-2027",
            "fax_number": "615-885-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528A OLD HICKORY BLVD",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762576",
            "telephone_number": "615-885-2027",
            "fax_number": "615-885-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODTN1334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

Verify at the official NPI Registry.