Individual provider Active NPI

Tammy Holsclaw-Jones OD PLLC, OD

  • Optometrist
  • Elizabethton, TN
National Provider Identifier
1891831160
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT0000001180 Issued in TN
Practice address
210 Rogosin Dr
Elizabethton, TN 37643-2906
Phone
(423) 543-6868
Fax
(423) 543-4226
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT0000001180 TN Primary

Addresses

Primary practice location

210 Rogosin Dr
Elizabethton, TN 37643-2906

Mailing address

210 Rogosin Dr
Elizabethton, TN 37643-2906
Phone (423) 543-6868

Other identifiers 1

IdentifierTypeStateIssuer
4024713OtherTNBLUE CROSS

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
I20120202000231 TN Practitioner - Optometry 8820109267 Receives reassigned benefits from 1 practitioner
Practice locations: Elizabethton, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Rogosin Dr
Elizabethton, TN 37643-2906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODT0000001180TNMDOptometrist
1180TNMDPhysical Therapist

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1891831160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ROGOSIN DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432906",
            "telephone_number": "423-543-6868",
            "fax_number": "423-543-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ROGOSIN DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432906",
            "telephone_number": "423-543-6868",
            "fax_number": "423-543-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSCLAW-JONES OD PLLC",
        "first_name": "TAMMY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT0000001180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4024713",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.