NPIMap

Organization Active NPI

Pomerance Eye Center, PC

  • Specialist
  • Chattanooga, TN
National Provider Identifier
1174534200
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
POMERANCE EYE CENTER, PC
Practice address
1801 Gunbarrel Rd
Chattanooga, TN 37421-3130
Phone
(423) 855-6800
Fax
(423) 855-1108
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Dr. Glenn N Pomerance, MDNPI 1609868017
Title
Owner
Phone
(423) 855-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1801 Gunbarrel Rd
Chattanooga, TN 37421-3130

Mailing address

1801 Gunbarrel Rd
Chattanooga, TN 37421-3130
Phone (423) 855-6800

Other identifiers 2

IdentifierTypeStateIssuer
3709593MedicaidTN
0393990001OtherTNSUPPLER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930014005 TN DME Supplier - Physician - Ophthalmology 6800878497 Practice locations: Chattanooga, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pomerance Eye Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2030 Hamilton Place Blvd
Ste 140
Chattanooga, TN 37421
Phone (423) 553-5635

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1174534200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 GUNBARREL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213130",
            "telephone_number": "423-855-6800",
            "fax_number": "423-855-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 GUNBARREL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213130",
            "telephone_number": "423-855-6800",
            "fax_number": "423-855-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMERANCE EYE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "POMERANCE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-855-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3709593",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLER NUMBER",
            "identifier": "0393990001",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.