Individual provider Active NPI

William Andrew Malec

  • Optometrist
  • Jackson, TN
National Provider Identifier
1972592152
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT1173 Issued in TN
Practice address
201 E Lafayette St
Jackson, TN 38301-6250
Phone
(731) 422-3811
Fax
(731) 422-5681
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT1173 TN Primary

Addresses

Primary practice location

201 E Lafayette St
Jackson, TN 38301-6250

Mailing address

201 E Lafayette St
Jackson, TN 38301-6217
Phone (731) 422-3811

Other identifiers 1

IdentifierTypeStateIssuer
3598725MedicaidTN

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
I20080613000093 TN Practitioner - Optometry 5496826778 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODT1173TNMDOptometrist
1173TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Vision Center, P.C. Optometrist CurrentSince Apr 14, 2008 Accepting new patients

Locations

201 E Lafayette St
Jackson, TN 38301
Phone (731) 422-3811

Organizations & group practices 1

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972592152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LAFAYETTE ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383016217",
            "telephone_number": "731-422-3811",
            "fax_number": "731-422-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LAFAYETTE ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383016250",
            "telephone_number": "731-422-3811",
            "fax_number": "731-422-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALEC",
        "first_name": "WILLIAM",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT1173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3598725",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.