Southeastern Retina Associates, P.C.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

SOUTHEASTERN RETINA ASSOCIATES, P.C.

Practice address

1961 Northpoint Blvd Ste 110
Hixson, TN 37343-4556

Phone

(423) 756-1002

NPI assigned

Mar 14, 2008

Organization subpart

No

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

Authorized official

Name

Andrew Laverghetta

Title

Ceo

Phone

(865) 474-7596

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

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

• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1932200664

  7517862360

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1932200664

  O20031204000507

  Same enrollment
• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Kingsport, TN
  • NPI 1932370145

  O20031204000507

  Same enrollment

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

CLIA laboratory certificates

Locations

Practitioners 27

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

• Nicholas Gray Anderson, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1972509297

  Retina Specialist, TN

  Medicare reassignment Care Compare group NPD
• Scott Matthew Barb, M.D.

  • Ophthalmology Physician
  • Knoxville, TN
  • NPI 1609137595

  Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Sophie Cai, MD

  • Ophthalmology Physician
  • Hixson, TN
  • NPI 1275914699

  GA, Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Jacob Tanner Cox, MD, MPHIL

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1811387061

  Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Francis C Decroos, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Hixson, TN
  • NPI 1871627554

  GA, Retina Specialist, TN

  Medicare reassignment Care Compare group NPD
• Jonathan Samuel Fuerst, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1811421555

  Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Devon Ghodasra, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Hixson, TN
  • NPI 1619298262

  GA, Retina Specialist, TN

  Medicare reassignment Care Compare group NPD
• Asghar Haider, MD

  • Retina Specialist (Ophthalmology) Physician
  • Hixson, TN
  • NPI 1801271457

  GA, Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Ailee Mark Laham, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1477791143

  Ophthalmology, TN

  Medicare reassignment Care Compare group NPD
• Tod Alan McMillan, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1023014347

  Retina Specialist, TN

  Medicare reassignment Care Compare group NPD
• James Howard Miller Jr., M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1710983721

  Retina Specialist, TN

  Medicare reassignment Care Compare group NPD
• Stephen Lee Perkins, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1427054436

  Retina Specialist, TN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1104097310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 EXECUTIVE PARK DR STE 202A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234670",
            "telephone_number": "865-588-0811",
            "fax_number": "865-934-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 NORTHPOINT BLVD STE 110",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434556",
            "telephone_number": "423-756-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN RETINA ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "LAVERGHETTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-474-7596"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3715425",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Pigott Soufleris
• Garrett C Soulen, DDS
• Southeast Senior Services LLC.
• Southeast Vision Rehabilitation, PLLC
• Southeastern Dental Associates of Hixson
• Southern Eyecare Associates Inc
• Lauren Taylor Souza, PA-C, DMS, MSW
• Amanda Yvette Sovago-Royal, LMT
• Specialized Oxygen Services, LLC
• Owen F Speer, DO

• Retina Specialist (Ophthalmology) Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• Retina Specialist (Ophthalmology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.