Kelli Jackson
Kelli Jackson is a healthcare organization registered as Optometrist in Cleveland, TN, holding Type 2 (organization) NPI 1619092574 since 2007. The authorized official on file is Kelli Jackson, Optometrist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1619092574 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Kelli Jackson |
| Practice address | 114 STUART RD NE, #102, Cleveland, TN, 37312 |
| Phone | 2529851371 |
| Enumeration date | 2007-03-20 |
| Last updated in NPPES | 2008-07-03 |
Authorized official
| Name | Kelli Jackson |
|---|---|
| Title | Optometrist |
| Phone | 2529851371 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 152W00000X | Optometrist | Primary | 1566 | TN |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00265658 | Other | TN | RAILROAD MEDICARE |
| 3940088 | Medicaid | TN | — |
| 4134928 | Other | TN | BCBS PROVIDER NUMBER |
Copy-ready billing details
Provider: Kelli Jackson NPI: 1619092574 Taxonomy: 152W00000X (Optometrist) Address: 114 STUART RD NE, #102, Cleveland, TN, 37312
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1134258338 | Cox Vision Center PC | Organization | Optometrist | Cleveland, TN |
| 1346379054 | Lavanya Tammareddi | Organization | Optometrist | Cleveland, TN |
| 1003931965 | Robert Patterson | Organization | Optometrist | Cleveland, TN |
| 1669597514 | Karin Moore | Organization | Optometrist | Cleveland, TN |
Verify this record
Cross-check NPI 1619092574 against the authoritative CMS record: view Kelli Jackson on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Kelli Jackson?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-07-03.