Organization Active NPI

Liberty Eye Care LLC

  • Optometrist
  • Athens, TN
National Provider Identifier
1154112977
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LIBERTY EYE CARE LLC
Practice address
1815 Decatur Pike
Athens, TN 37303-4932
Phone
(423) 745-5100
Fax
(423) 815-1554
NPI assigned
May 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Dr. Eric Selander, OD
Title
Owner
Phone
(423) 745-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1815 Decatur Pike
Athens, TN 37303-4932

Mailing address

1815 Decatur Pike
Athens, TN 37303-4932
Phone (423) 745-5100

Other names 1

  • LIBERTY EYE CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250619001044 TN Part B Supplier - Clinic/Group Practice 4587175120 Practice locations: Athens, TN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1154112977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 DECATUR PIKE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034932",
            "telephone_number": "423-745-5100",
            "fax_number": "423-815-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 DECATUR PIKE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034932",
            "telephone_number": "423-745-5100",
            "fax_number": "423-815-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "SELANDER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-745-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIBERTY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LIBERTY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.