Organization Active NPI

Greeneville Eye Clinic

  • Ophthalmology Physician
  • Greeneville, TN
National Provider Identifier
1114190535
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GREENEVILLE EYE CLINIC
Practice address
1406 Tusculum Blvd
Mob 2, Suite 1000
Greeneville, TN 37745-4332
Phone
(423) 639-6848
Fax
(423) 787-7210
NPI assigned
Apr 7, 2008
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Thomas Lloyd BrownNPI 1851400758
Title
Partner
Phone
(423) 639-6848

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1406 Tusculum Blvd
Mob 2, Suite 1000
Greeneville, TN 37745-4332

Mailing address

1406 Tusculum Blvd
Mob 2, Suite 1000
Greeneville, TN 37745-4332
Phone (423) 639-6848

Other identifiers 1

IdentifierTypeStateIssuer
3370294MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080509000221 TN Part B Supplier - Clinic/Group Practice 2264511690 Receives reassigned benefits from 2 practitioners
Practice locations: Greenville, TN

National Provider Directory

National Provider Directory

Locations

1406 Tusculum Blvd
Ste 1000
Greeneville, TN 37745
Phone (423) 639-6848

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1114190535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 TUSCULUM BLVD",
            "address_2": "MOB 2, SUITE 1000",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454332",
            "telephone_number": "423-639-6848",
            "fax_number": "423-787-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 TUSCULUM BLVD",
            "address_2": "MOB 2, SUITE 1000",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454332",
            "telephone_number": "423-639-6848",
            "fax_number": "423-787-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENEVILLE EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "423-639-6848"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370294",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.