Organization Active NPI

Burnett and Hubbard Eyecare PLLC

  • Optometrist
  • Jackson, TN
National Provider Identifier
1013102284
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
886 Issued in TN
Legal business name
BURNETT AND HUBBARD EYECARE PLLC
Practice address
214 Carriage House Dr
Jackson, TN 38305-3903
Phone
(731) 668-4881
Fax
(731) 668-5705
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Dr. Charlene Burnett, O.D.NPI 1114927761
Title
Partner/Optometrist
Phone
(731) 668-4881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 886 TN Primary

Addresses

Primary practice location

214 Carriage House Dr
Jackson, TN 38305-3903

Mailing address

214 Carriage House Dr
Jackson, TN 38305-3903
Phone (731) 668-4881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101104001098 TN Part B Supplier - Clinic/Group Practice 9234256579 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

214 Carriage House Dr
Jackson, TN 38305
Phone (731) 668-4881

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1013102284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CARRIAGE HOUSE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053903",
            "telephone_number": "731-668-4881",
            "fax_number": "731-668-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CARRIAGE HOUSE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053903",
            "telephone_number": "731-668-4881",
            "fax_number": "731-668-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNETT AND HUBBARD EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "PARTNER/OPTOMETRIST",
        "authorized_official_telephone_number": "731-668-4881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.