Individual provider Active NPI

David Anthony Pifer, OD

  • Optometrist
  • Chattanooga, TN
National Provider Identifier
1144333733
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN1896 Issued in TN
Practice address
629 Market St
Suite 115
Chattanooga, TN 37402-4884
Phone
(423) 265-4306
Fax
(423) 265-4404
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TN1896 TN Primary

Addresses

Primary practice location

629 Market St
Suite 115
Chattanooga, TN 37402-4884

Mailing address

PO Box 1636
Chattanooga, TN 37401-1636
Phone (423) 265-4306

Other identifiers 1

IdentifierTypeStateIssuer
3942008MedicaidTN

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
I20040130000897 TN Practitioner - Optometry 6507768660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1732GAMDPsychologist
TN1896TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Jan 29, 2018 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Jan 29, 2018 Accepting new patients
Deborah R. Distefano M.D.P.C. Past Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Locations

629 Market St
Ste 115
Chattanooga, TN 37402
Phone (423) 265-4306

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1144333733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1636",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374011636",
            "telephone_number": "423-265-4306",
            "fax_number": "423-265-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 MARKET ST",
            "address_2": "SUITE 115",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374024884",
            "telephone_number": "423-265-4306",
            "fax_number": "423-265-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIFER",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN1896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3942008",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.