Individual provider Active NPI

Brent W Jones, O.D.

  • Optometrist
  • Collierville, TN
National Provider Identifier
1891809406
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2372 Issued in TN
Practice address
472 W Poplar Ave Ste 102
Collierville, TN 38017-2595
Phone
(901) 329-8055
Fax
(901) 234-0133
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2372 TN Primary

Addresses

Primary practice location

472 W Poplar Ave Ste 102
Collierville, TN 38017-2595

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20070410000703 TN Practitioner - Optometry 7113022773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Tennessee LLCGroup PAC ID 1759646995, 45 clinicians

Practice addresses (Care Compare)

472 W Poplar Ave
Suite 102
Collierville, TN 38017-2595
Phone (901) 329-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2372TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist Current Accepting new patients

Locations

2817 Bartlett Blvd
Bartlett, TN 38134
Phone (901) 371-0770

629 Market St
Ste 115
Chattanooga, TN 37402
Phone (423) 265-4306

472 W Poplar Ave
Ste 102
Collierville, TN 38017
Phone (901) 329-8055

1605 N Germantown Pkwy
Ste 101
Cordova, TN 38016
Phone (901) 379-2021

2075 Exeter Rd
Ste 70
Germantown, TN 38138
Phone (901) 754-2020

6150 Poplar Ave
Ste 115
Memphis, TN 38119
Phone (901) 682-3937

7825 Winchester Rd
Ste 117
Memphis, TN 38125
Phone (901) 365-9732

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1891809406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 W POPLAR AVE STE 102",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172595",
            "telephone_number": "901-329-8055",
            "fax_number": "901-234-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BRENT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.