Organization Active NPI

Southern Vision Eye Care LLC

  • Optometrist
  • Oneonta, AL
National Provider Identifier
1023630985
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SOUTHERN VISION EYE CARE LLC
Practice address
230 1St Ave E
Oneonta, AL 35121-1734
Phone
(205) 625-5520
Fax
(205) 810-0564
NPI assigned
May 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Molly Tipton, ODNPI 1679066401
Title
OD
Phone
(205) 625-5520

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 Primary

Addresses

Primary practice location

230 1St Ave E
Oneonta, AL 35121-1734

Mailing address

230 1St Ave E
Oneonta, AL 35121-1734
Phone (205) 625-5520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323001643 AL Part B Supplier - Clinic/Group Practice 2365859170 Receives reassigned benefits from 2 practitioners
Practice locations: Oneonta, AL

National Provider Directory

National Provider Directory

Locations

230 1st Ave E
Oneonta, AL 35121
Phone (205) 625-5520

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": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1023630985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 1ST AVE E",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211734",
            "telephone_number": "205-625-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 1ST AVE E",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351211734",
            "telephone_number": "205-625-5520",
            "fax_number": "205-810-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN VISION EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-14",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "TIPTON",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "205-625-5520",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.