Active NPI
Southern Vision Eye Care LLC
- Optometrist
- Oneonta, AL
National Provider Identifier
1023630985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Molly Tipton, OD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210323001643 | AL | Part B Supplier - Clinic/Group Practice | 2365859170 |
Receives reassigned benefits from 2 practitioners Practice locations: Oneonta, AL |
National Provider Directory
National Provider DirectoryLocations
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.