Individual provider Active NPI

Jamie Myers, OD

  • Optometrist
  • Appleton, WI
National Provider Identifier
1932820123
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3816 Issued in WI
Practice address
3142 N Richmond St
Appleton, WI 54911-1151
Phone
(920) 499-3102
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 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 3816 WI Primary

Addresses

Primary practice location

3142 N Richmond St
Appleton, WI 54911-1151

Mailing address

3142 N Richmond St
Appleton, WI 54911-1151
Phone (321) 246-5376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220927000857 WI Practitioner - Optometry 4880070960 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
Tower Clock Eye Center SCGroup PAC ID 6305890781, 8 clinicians

Practice addresses (Care Compare)

1087 W Mason St
Green Bay, WI 54303-1859
Phone (920) 499-3102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3816WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Clock Eye Center SC Optometrist CurrentSince Nov 1, 2022 Accepting new patients
Tower Clock Eye Center SC CurrentSince Nov 1, 2022 Accepting new patients

Locations

3142 N Richmond St
Appleton, WI 54911
Phone (920) 499-3102

1087 W Mason St
Green Bay, WI 54303
Phone (920) 499-3102

Interoperability endpoints

  • Direct secure messaging: jamie.myers@towerclockeyecenter.direct.eyemdemr.com

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1932820123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111151",
            "telephone_number": "321-246-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111151",
            "telephone_number": "920-499-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.