Individual provider Active NPI

Jared Dix, OD

  • Optometrist
  • Maryville, TN
National Provider Identifier
1891427787
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3748 Issued in TN
Practice address
730 W Lamar Alexander Pkwy
Maryville, TN 37801-3900
Phone
(865) 982-2020
NPI assigned
Jun 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3748 TN Primary

Addresses

Primary practice location

730 W Lamar Alexander Pkwy
Maryville, TN 37801-3900

Mailing address

6719 Maynardville Pike
Knoxville, TN 37918-5308
Phone (865) 922-3937

Other practice location 1

6719 Maynardville Pike
Knoxville, TN 37918-5308
Phone (865) 922-3937

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
I20221026000104 TN Practitioner - Optometry 0345616751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven Elliott OD and Associates IncGroup PAC ID 3577752526, 9 clinicians

Practice addresses (Care Compare)

730 W Lamar Alexander Pkwy
Maryville, TN 37801-3900
Phone (865) 970-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3748TNMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven D. Elliott, O.D. & Associates, Inc. Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1891427787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 MAYNARDVILLE PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379185308",
            "telephone_number": "865-922-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378013900",
            "telephone_number": "865-982-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6719 Maynardville Pike",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379185308",
            "country_code": "US",
            "telephone_number": "865-922-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIX",
        "first_name": "JARED",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.