Organization Active NPI

Robert Patterson

  • Optometrist
  • Cleveland, TN
National Provider Identifier
1003931965
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1612 Issued in TN
Legal business name
ROBERT PATTERSON
Practice address
114 Stuart Rd NE
#102
Cleveland, TN 37312-4803
Phone
(252) 985-1371
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Robert S Patterson, OD
Title
Optometrist
Phone
(252) 985-1371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1612 TN Primary

Addresses

Primary practice location

114 Stuart Rd NE
#102
Cleveland, TN 37312-4803

Mailing address

PO Box 7396
Rocky Mount, NC 27804-0396

Other identifiers 3

IdentifierTypeStateIssuer
3941325MedicaidTN
4125087OtherTNBCBS PROVIDER NUMBER
P00258494OtherTNRAILROAD MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Robert Patterson2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1003931965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7396",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STUART RD NE",
            "address_2": "#102",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124803",
            "telephone_number": "252-985-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT PATTERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "252-985-1371",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941325",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "4125087",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00258494",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.