Individual provider Active NPI

Jason C Clopton, O.D.

  • Optometrist
  • Cookeville, TN
National Provider Identifier
1972507614
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT2014 Issued in TN
Practice address
1080 Neal St
Ste 300
Cookeville, TN 38501-4038
Phone
(931) 372-2567
Fax
(931) 372-2572
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT2014 TN Primary
Pediatric Optometrist 152WP0200X ODT2014 TN
Vision Therapy Optometrist 152WV0400X ODT2014 TN

Addresses

Primary practice location

1080 Neal St
Ste 300
Cookeville, TN 38501-4038

Mailing address

1080 Neal St
Ste 300
Cookeville, TN 38501-4038
Phone (931) 372-2567

Other identifiers 1

IdentifierTypeStateIssuer
3942934MedicaidTN

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
I20080226000157 TN Practitioner - Optometry 7315933165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1445 E 10TH St
Cookeville, TN 38501-2017
Phone (931) 372-2567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODT2014TNMDVision Therapy Optometrist
2014TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Vision Development, PLLC Optometrist CurrentSince Jul 31, 2002 Accepting new patients
Centers of Development, PLLC PastSince Jul 31, 2002 Accepting new patients
Lighthouse Optical of Tennessee, LLC Optometrist PastSince Aug 1, 2019 Accepting new patients

Locations

1445 E 10th St
Cookeville, TN 38501
Phone (931) 372-2020

1080 Neal St
Ste 300
Cookeville, TN 38501
Phone (931) 372-2567

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1972507614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 NEAL ST",
            "address_2": "STE 300",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014038",
            "telephone_number": "931-372-2567",
            "fax_number": "931-372-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 NEAL ST",
            "address_2": "STE 300",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014038",
            "telephone_number": "931-372-2567",
            "fax_number": "931-372-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOPTON",
        "first_name": "JASON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT2014",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "ODT2014",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "ODT2014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3942934",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.