Tommy J. Ducklo, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0696 Issued in TN

Practice address

2114 Elliston PL.
Nashville, TN 37203

Phone

(615) 329-0000

Fax

(615) 327-2431

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Hermitage Eye Care PLLC

  • Optometrist
  • Hermitage, TN
  • NPI 1275943052
  Medicare reassignment NPD
• Hermitage Eye Care PLLC

  • Optometrist
  • Brentwood, TN
  • NPI 1689479909
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1881797728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 ELLISTON PL.",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-329-0000",
            "fax_number": "615-327-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 ELLISTON PL.",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-329-0000",
            "fax_number": "615-327-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKLO",
        "first_name": "TOMMY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "0696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3594535",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410009236",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "620947940",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "620947940",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "2008478",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Dubois, MD
• Jane Smith Dubose, APRN, BC
• Bernard John Dubray Jr., M.D.
• Mary L Dubuisson, RN
• John Matthew Ducey, M.D.
• Kathryn Duckworth, MD
• Taylor Tracy Duckworth, DDS
• Dawn E. Ducote, LCSW
• Julian Christopher Duda, M.D.
• Martha E Dudek, MS LCGC

• Optometrist in Nashville, TN
• Providers in Nashville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.