Eyecare Revolution LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2871 Issued in TN

Legal business name

EYECARE REVOLUTION LLC

Practice address

3070 Mallory LN
Franklin, TN 37067-8304

Phone

(615) 771-4006

NPI assigned

Apr 1, 2010

Organization subpart

No

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

Authorized official

Name

Jennifer Nance, O.D.

Title

Managing Member

Phone

(615) 771-4006

Specialties & licenses 2

Addresses

Other names 1

• Lifetime Family Eyecare Doing business as

Locations

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1194040246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MALLORY LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678304",
            "telephone_number": "615-771-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 MALLORY LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678304",
            "telephone_number": "615-771-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE REVOLUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-01",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "615-771-4006",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2871",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eye Care of Franklin, LLC
• Eyecare Plus CS PLLC
• Eyecare Specialties, LLC
• Joshua Matt Ezell, ATC
• Lori Ann Fagan, P.T.
• Tamra Ann Fagan, PH.D.
• Molly McGill Fahey

• All providers in Franklin, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.