Optometry Group Enterprises, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT 1585 Issued in TN

Legal business name

OPTOMETRY GROUP ENTERPRISES, PC

Practice address

2961 Canada Rd
Suite 104
Lakeland, TN 38002-4893

Phone

(901) 380-2020

Fax

(901) 380-2809

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bart L. Powell, O.D.

Title

Owner-Doctor

Phone

(901) 380-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Optometry Group Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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

• Barton L. Powell, O.D.

  • Optometrist
  • Lakeland, TN
  • NPI 1164572285
  Medicare reassignment NPD
• Jonathan William Wilson, O.D.

  • Optometrist
  • Southaven, MS
  • NPI 1881738532
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1104968338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 CANADA RD",
            "address_2": "SUITE 104",
            "city": "LAKELAND",
            "state": "TN",
            "postal_code": "380024893",
            "telephone_number": "901-380-2020",
            "fax_number": "901-380-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 CANADA RD",
            "address_2": "SUITE 104",
            "city": "LAKELAND",
            "state": "TN",
            "postal_code": "380024893",
            "telephone_number": "901-380-2020",
            "fax_number": "901-380-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRY GROUP ENTERPRISES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "BART",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER-DOCTOR",
        "authorized_official_telephone_number": "901-380-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT 1585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3940102",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optometry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tequa Mims
• James Eli Mullins IV, FNP
• Myeyedr Optometry of Tennessee, LLC
• Bruce Cole Newton, CCP, LCP
• Next Level Living, Inc.
• Uday Patel
• Brittni Patterson, MSN, NP-C
• Barton L. Powell, O.D.
• Premier Pediatrics of Memphis, PLLC
• Michelle Denise Reeves, PHAM. D.

• All providers in Lakeland, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.