Active NPI
Clayton B Rhodes, O.D.
- Optometrist
- Hixson, TN
National Provider Identifier
1194719674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD507
- Practice address
- 5433 Hixson Pike
Hixson, TN 37343-3238 - Phone
- (423) 843-2020
- Fax
- (423) 842-1914
- NPI assigned
- Sep 9, 2005
- Reactivated
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD507 | TN | Primary |
Addresses
Primary practice location
5433 Hixson Pike
Hixson, TN 37343-3238
Mailing address
5433 Hixson Pike
Hixson, TN 37343-3238
Phone (423) 843-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0400520001 | Other | TN | MEDICARE, DME MAC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 507 | TN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1194719674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5433 HIXSON PIKE",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433238",
"telephone_number": "423-843-2020",
"fax_number": "423-842-1914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5433 HIXSON PIKE",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433238",
"telephone_number": "423-843-2020",
"fax_number": "423-842-1914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODES",
"first_name": "CLAYTON",
"middle_name": "B",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2014-10-06",
"deactivation_date": "2006-03-25",
"reactivation_date": "2006-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "OD507",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE, DME MAC",
"identifier": "0400520001",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.