Danny W Cross, OD
Individual provider Active NPI Optometrist · Oneida, TN
NPI 1013079474 · NPPES record last updated Apr 6, 2015
Key facts
- NPI
- 1013079474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 717OD (TN)
- Practice address
- 18730 Alberta St
Oneida, TN 37841-2128 - Phone
- (423) 569-6822
- Fax
- (423) 569-6823
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 717OD | TN | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 717OD | TN | Yes |
Addresses
Primary practice location
18730 Alberta St
Oneida, TN 37841-2128
Mailing address
PO Box 4509
Oneida, TN 37841-4509
Phone (423) 569-6822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103I416993 | Other | MEDICARE PTAN | |
| 3594379 | Medicaid | TN |
Other providers in Oneida, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.