NPIMap

Organization Active NPI

Eyecare Plus MB PLLC

  • Optometrist
  • Murfreesboro, TN
National Provider Identifier
1043684293
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE PLUS MB PLLC
Practice address
419 Memorial Blvd
Murfreesboro, TN 37129-2759
Phone
(615) 601-3888
NPI assigned
Nov 25, 2015
Last updated
Aug 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Cheyanne Mullis
Title
Credentialing Manager
Phone
(615) 988-5303

Specialties & licenses 1

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

Addresses

Primary practice location

419 Memorial Blvd
Murfreesboro, TN 37129-2759

Mailing address

419 Memorial Blvd
Murfreesboro, TN 37129-2759
Phone (615) 601-3888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160629001584 TN Part B Supplier - Clinic/Group Practice 0840581427 Receives reassigned benefits from 14 practitioners
Practice locations: Murfreesboro, TN

National Provider Directory

National Provider Directory

Locations

419 Memorial Blvd
Murfreesboro, TN 37129
Phone (615) 601-3888

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1043684293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292759",
            "telephone_number": "615-601-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292759",
            "telephone_number": "615-601-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PLUS MB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "MULLIS",
        "authorized_official_first_name": "CHEYANNE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "615-988-5303"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.