Individual provider Active NPI

Susan N Kegarise, O.D.

  • Optometrist
  • Nashville, TN
National Provider Identifier
1184617680
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1459 Issued in TN
Practice address
524B Donelson Pike
Nashville, TN 37214-3729
Phone
(615) 889-0147
Fax
(615) 889-2700
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1459 TN Primary

Addresses

Primary practice location

524B Donelson Pike
Nashville, TN 37214-3729

Mailing address

524B Donelson Pike
Nashville, TN 37214-3729
Phone (615) 889-0147

Other identifiers 1

IdentifierTypeStateIssuer
62-1827648OtherTNTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1459TNMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Donelson Eyecare, PLLC Optometrist CurrentSince Jan 1, 2001 Accepting new patients

Locations

3252 Aspen Grove Dr
Ste 1
Franklin, TN 37067
Phone (615) 771-7555

524 Donelson Pike
#B
Nashville, TN 37214
Phone (615) 889-0147

524B Donelson Pike
Nashville, TN 37214
Phone (615) 889-0147

2378 Lebanon Pike
Nashville, TN 37214
Phone (615) 889-0147

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184617680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524B DONELSON PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143729",
            "telephone_number": "615-889-0147",
            "fax_number": "615-889-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524B DONELSON PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143729",
            "telephone_number": "615-889-0147",
            "fax_number": "615-889-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGARISE",
        "first_name": "SUSAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "62-1827648",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.