Individual provider Active NPI

Amy H Vinogradov, OD

  • Optometrist
  • Dandridge, TN
National Provider Identifier
1164914461
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3537 Issued in TN
Practice address
334 Highway 92 S Ste 7
Dandridge, TN 37725-4578
Phone
(865) 397-9991
Fax
(865) 940-1401
NPI assigned
Jun 1, 2018
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T-236-TA-B19 AL
Optometrist 152W00000X 3537 TN Primary

Addresses

Primary practice location

334 Highway 92 S Ste 7
Dandridge, TN 37725-4578

Mailing address

334 Highway 92 S Ste 7
Dandridge, TN 37725-4578
Phone (865) 397-9991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180807003711 AL Practitioner - Optometry 9931457991 Reassigns benefits to 1 organization
I20220118000685 TN Practitioner - Optometry 9931457991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnes Vision PLLCGroup PAC ID 3779628607, 3 clinicians

Practice addresses (Care Compare)

334 Hwy 92 S
Suite 7
Dandridge, TN 37725-4578
Phone (865) 397-9991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham CurrentSince Jun 18, 2018 Accepting new patients
The University of Alabama at Birmingham Optometrist CurrentSince Jun 18, 2018 Accepting new patients
Barnes Vision PLLC Optometrist CurrentSince Feb 1, 2022 Accepting new patients

Locations

1716 University Blvd
Birmingham, AL 35233
Phone (205) 934-3899

1716 University Blvd
Birmingham, AL 35294

1716 University Blvd
#G90A
Birmingham, AL 35233

334 Highway 92 S
Ste 7
Dandridge, TN 37725
Phone (865) 397-9991

Interoperability endpoints

  • Direct secure messaging: amy.vinogradov@direct.revolutionehr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1164914461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 HIGHWAY 92 S STE 7",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254578",
            "telephone_number": "865-397-9991",
            "fax_number": "205-934-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 HIGHWAY 92 S STE 7",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254578",
            "telephone_number": "865-397-9991",
            "fax_number": "865-940-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINOGRADOV",
        "first_name": "AMY",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "T-236-TA-B19",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dandridge, TN

Sources for this page

Verify at the official NPI Registry.