Zeke Parker Grissom, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3676 Issued in TN

Practice address

915 Colloredo Blvd
Shelbyville, TN 37160-2780

Phone

(931) 684-2197

Fax

(931) 229-1112

NPI assigned

Jul 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bedford Vision and Eye Clinic PLLCGroup PAC ID 8527318385, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bedford Vision and Eye Clinic PLLC

  • Optometrist
  • Shelbyville, TN
  • NPI 1992217756
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1164095758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 GREGORY MILL RD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371605565",
            "telephone_number": "931-703-9954",
            "fax_number": "931-229-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602780",
            "telephone_number": "931-684-2197",
            "fax_number": "931-229-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "ZEKE",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gray
• Jeremy Gray
• Carol A Green, RN
• Andre Gregory, DC MS
• Laura Bethany Griffin, PTA
• Christina Grover, FNP-C
• Guardian Pharmacy of TN One
• Sinia Guzman- Brown
• Steven Frank Haber, LMT
• Camillia Rae Hadley

• Optometrist in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.