Cookeville Eye Specialists, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T1567 Issued in TN

Legal business name

COOKEVILLE EYE SPECIALISTS, PLLC

Practice address

1125 Perimeter Park Dr Ste 200
Cookeville, TN 38501-0912

Phone

(931) 528-1304

Fax

(931) 372-8958

NPI assigned

Feb 21, 2007

Last updated

Mar 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Misty Dawn Lynch

Title

Billing

Phone

(931) 528-1304

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Cookeville Eye Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Crossville, TN
  • NPI 1316540487

  5294757985

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Cookeville Eye Specialists PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Cookeville Eye Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Crossville, TN
  • NPI 1316540487
  NPD tax ID
• Cookeville Eye Specialists, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Sparta, TN
  • NPI 1437090529
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cory J. Bosanko, O.D.

  • Low Vision Rehabilitation Optometrist
  • Crossville, TN
  • NPI 1730180704
  Medicare reassignment Care Compare group NPD
• Brittany B Denaro, DO

  • Ophthalmology Physician
  • Cookeville, TN
  • NPI 1356702773

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michael Stewart Galloway, M.D.

  • Ophthalmology Physician
  • Crossville, TN
  • NPI 1063491421
  Medicare reassignment Care Compare group NPD
• Michael Paul Jones, M.D.

  • Ophthalmology Physician
  • Cookeville, TN
  • NPI 1164589164
  Medicare reassignment Care Compare group NPD
• Caitlin Millsaps, OD

  • Optometrist
  • Sparta, TN
  • NPI 1518731918
  Medicare reassignment Care Compare group NPD
• Jennifer L Peek, OD

  • Optometrist
  • Sparta, TN
  • NPI 1568660181
  Medicare reassignment Care Compare group NPD
• Faramarz Fred Hidaji, MD

  • Ophthalmology Physician
  • Memphis, TN
  • NPI 1518956119
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1033254289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 PERIMETER PARK DR STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010912",
            "telephone_number": "931-528-1304",
            "fax_number": "931-372-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 PERIMETER PARK DR STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010912",
            "telephone_number": "931-528-1304",
            "fax_number": "931-372-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKEVILLE EYE SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "931-528-1304"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "T1567",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD024999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cookeville Cardiac Anesthesia, P.C.
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• Cookeville Chiropractic and Physical Therapy, P.C.
• Cookeville Discount Pharmacy (Cookeville Med Plus Pharmacy)
• Cookeville Hospitalist Group, PLLC
• Cookeville Medical Center PC (Cookeville Medical Center)
• Cookeville Neurology
• Cookeville Oral Surgery, PLLC
• Cookeville Pathology Lab

• Optometrist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.