Individual provider Active NPI

Lisa Sanford Howard, O.D.

  • Optometrist
  • Middlesboro, KY
National Provider Identifier
1124024302
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1082 DT Issued in KY
Practice address
1403 Cumberland Ave
Ste a
Middlesboro, KY 40965-1158
Phone
(606) 248-2549
Fax
(606) 248-9188
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1082 DT KY Primary
Vision Therapy Optometrist 152WV0400X 1082DT KY

Addresses

Primary practice location

1403 Cumberland Ave
Ste a
Middlesboro, KY 40965-1158

Mailing address

PO Box 979
Middlesboro, KY 40965-0979
Phone (606) 248-2549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130718000507 TN Practitioner - Optometry 5092877282 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1082 DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rogersville Vision Clinic,PLLC Optometrist CurrentSince Jul 24, 2012 Accepting new patients
Dr. Torrey J. Carlson & Associates Optometrist CurrentSince Aug 8, 2024 Accepting new patients
Southeast Eye Associates, PLLC Optometrist PastSince Aug 2, 2002 Accepting new patients
Rogersville Vision Clinic, PLLC Optometrist PastSince Jun 5, 2013 Accepting new patients

Locations

2600 E Stone Dr
Ste 10
Kingsport, TN 37660
Phone (865) 217-1010

5415 Washington Pike
Knoxville, TN 37918
Phone (423) 217-1010

7600 Kingston Pike
Ste 1480
Knoxville, TN 37919
Phone (865) 217-1010

2020 Chapman Hwy
Ste 1
Knoxville, TN 37920
Phone (865) 573-2443

107 E Main St
Rogersville, TN 37857
Phone (423) 272-2020

311 E Main St
Rogersville, TN 37857
Phone (423) 272-2020

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1124024302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 979",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409650979",
            "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": "STE A",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651158",
            "telephone_number": "606-248-2549",
            "fax_number": "606-248-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "LISA",
        "middle_name": "SANFORD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1082 DT",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "KY",
            "license": "1082DT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

Verify at the official NPI Registry.