Active NPI
Eyecare Plus CL PLLC
- Optometrist
- Clarksville, TN
National Provider Identifier
1104871037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- EYECARE PLUS CL PLLC
- Practice address
- 2024 Wilma Rudolph Blvd
Clarksville, TN 37040-6879 - Phone
- (931) 551-3031
- Fax
- (931) 552-7488
- NPI assigned
- May 22, 2006
- Reactivated
- Apr 24, 2024
- 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
- Cheyanne Mullis
- Title
- Office Manager
- Phone
- (615) 988-5303
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
2024 Wilma Rudolph Blvd
Clarksville, TN 37040-6879
Mailing address
2024 Wilma Rudolph Blvd
Suite C
Clarksville, TN 37040-6620
Phone (931) 551-3031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031118000032 | TN | Part B Supplier - Clinic/Group Practice | 3870407406 |
Receives reassigned benefits from 11 practitioners Practice locations: Clarksville, TN |
National Provider Directory
National Provider DirectoryLocations
5323 Mount View Rd
Antioch, TN 37013
Phone (615) 731-8900
2024 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (931) 551-3031
1911 Glen Echo Rd
Nashville, TN 37215
Phone (615) 298-2668
Practitioners & affiliated clinicians
Practitioners 20
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Nashville, TN
- NPI 1538851555
-
- Optometrist
- Murfreesboro, TN
- NPI 1114779774
-
- Optometrist
- Clarksville, TN
- NPI 1508621996
-
- Optometrist
- Nashville, TN
- NPI 1518795194
-
- Student in an Organized Health Care Education/Training Program
- Memphis, TN
- NPI 1861332280
TN
-
- Optometrist
- Brentwood, TN
- NPI 1861482093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713916800000",
"number": "1104871037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2024 WILMA RUDOLPH BLVD",
"address_2": "SUITE C",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370406620",
"telephone_number": "931-551-3031",
"fax_number": "931-552-7488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2024 WILMA RUDOLPH BLVD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370406879",
"telephone_number": "931-551-3031",
"fax_number": "931-552-7488"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYECARE PLUS CL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-22",
"last_updated": "2024-04-24",
"certification_date": "2021-08-05",
"deactivation_date": "2024-02-23",
"reactivation_date": "2024-04-24",
"status": "A",
"authorized_official_last_name": "MULLIS",
"authorized_official_first_name": "CHEYANNE",
"authorized_official_title_or_position": "OFFICE 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 Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.