Individual provider Active NPI

Joseph Summers, OD

  • Optometrist
  • Arrington, TN
National Provider Identifier
1902961402
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD2150 Issued in TN
Practice address
1133 Meadow Bridge LN
Arrington, TN 37014-9109
Phone
(615) 319-5630
Fax
(615) 376-9318
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1133 Meadow Bridge LN
Arrington, TN 37014-9109

1585 Mallory LN
Suite 104
Brentwood, TN 37027-3036
Phone (615) 376-9317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20041209000976 TN Practitioner - Optometry 5395701486 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD2150TNMDOptometrist
2150TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Joey Summers Optical Optometrist CurrentSince Oct 10, 2015 Accepting new patients
Dr Mark Lynn & Associates PLLC Past Accepting new patients
Ky Doctors of Optometry, PLLC Past Accepting new patients

Locations

1585 Mallory Ln
Ste 104
Brentwood, TN 37027
Phone (615) 319-5630

1655 W College St
Pulaski, TN 38478
Phone (931) 309-3168

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD2150 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

1133 Meadow Bridge LN
Arrington, TN 37014-9109

Mailing address

1133 Meadow Bridge LN Ste 6
Arrington, TN 37014-9109
Phone (615) 319-5630

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3943591MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 21, 2020.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1902961402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEADOW BRIDGE LN STE 6",
            "city": "ARRINGTON",
            "state": "TN",
            "postal_code": "370149109",
            "telephone_number": "615-319-5630",
            "fax_number": "615-376-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 MEADOW BRIDGE LN",
            "city": "ARRINGTON",
            "state": "TN",
            "postal_code": "370149109",
            "telephone_number": "615-319-5630",
            "fax_number": "615-376-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD2150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3943591",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arrington, TN

Sources for this page

Verify at the official NPI Registry.