Barton L. Powell, O.D.
Individual provider Active NPI Optometrist · Lakeland, TN
NPI 1164572285 · NPPES record last updated Jul 19, 2012
Key facts
- NPI
- 1164572285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- ODT1585 (TN)
- Practice address
- 2961 Canada Rd
Ste 104
Lakeland, TN 38002-4893 - Phone
- (901) 380-2020
- Fax
- (901) 380-2809
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2961 Canada Rd
Lakeland, TN 38002-4893
Phone (901) 380-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031110000114 | TN | Practitioner - Optometry | 4981517679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1585 | TN | MD | Marriage & Family Therapist |
| ODT1585 | TN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optometry Group Enterprises, PC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Tennessee, LLC | Optometrist | Past | Accepting new patients |
Locations
2961 Canada Rd
Ste 104
Lakeland, TN 38002
Phone (901) 380-2020
3115 S Mendenhall Rd
Memphis, TN 38115
Phone (901) 794-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODT1585 | TN | Yes |
Addresses
Primary practice location
2961 Canada Rd
Ste 104
Lakeland, TN 38002-4893
Mailing address
3959 Herons Retreat CV
Lakeland, TN 38002-8498
Phone (901) 867-9692
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3940102 | Medicaid | TN |
Other providers in Lakeland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.