NPIMap

Organization Active NPI

Southeast Eye Associates, PLLC

  • Optometrist
  • Middlesboro, KY
National Provider Identifier
1104952928
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1082 DT Issued in KY
Legal business name
SOUTHEAST EYE ASSOCIATES, PLLC
Practice address
1403 Cumberland Ave
Suite a, Box 979
Middlesboro, KY 40965-1158
Phone
(606) 248-2549
Fax
(606) 248-9188
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Authorized official

Name
Dr. Lisa S Howard, ODNPI 1124024302
Title
Owner
Phone
(606) 248-2549

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1082 DT KY Primary

Addresses

Primary practice location

1403 Cumberland Ave
Suite a, Box 979
Middlesboro, KY 40965-1158

Mailing address

1403 Cumberland Ave
Suite a
Middlesboro, KY 40965-1158
Phone (606) 248-2549

Other identifiers 1

IdentifierTypeStateIssuer
7265OtherMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1403 Cumberland Ave
Ste A
Middlesboro, KY 40965
Phone (606) 248-2549

1403 Cumberland Ave
#A1
Middlesboro, KY 40965
Phone (606) 248-2549

Practitioners & affiliated clinicians

Practitioners 9

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1104952928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 CUMBERLAND AVE",
            "address_2": "SUITE A",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651158",
            "telephone_number": "606-248-2549",
            "fax_number": "606-248-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 CUMBERLAND AVE",
            "address_2": "SUITE A, BOX 979",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651158",
            "telephone_number": "606-248-2549",
            "fax_number": "606-248-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST EYE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-248-2549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1082 DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7265",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.