Trey Amerson Pegram, M.D.

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

TN-55555 Issued in TN

Practice address

306 Landrum Place
Clarksville, TN 37043-4648

Phone

(931) 221-9544

Fax

(931) 444-5111

NPI assigned

May 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Tennessee, HSC, College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.61 of 100Reported as individual

Quality

85.22

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pegram@eyesthetics.emadirect.md

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.

• Eyesthetics PLLC

  • Ophthalmology Physician
  • Clarksville, TN
  • NPI 1598374902

  KY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1205128352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 LANDRUM PLACE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434648",
            "telephone_number": "931-221-9544",
            "fax_number": "931-444-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 LANDRUM PLACE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434648",
            "telephone_number": "931-221-9544",
            "fax_number": "931-444-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7268 Jarnigan Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374213097",
            "country_code": "US",
            "telephone_number": "423-508-7337",
            "fax_number": "423-508-7338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "TREY",
        "middle_name": "AMERSON",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2023-08-14",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "MD-55555",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q2364",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "TN-55555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029682",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpegram@southeasteye.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Greenway PrimeSuite",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3443 Dickerson Pike Ste 240",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372072522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Joel Pedigo, MD
• Pedro T. Salcedo, M.D.,PLC
• Lastacia Peele
• Brandy Denise Peet
• Katie Greene Pegram, MD
• Emily Pellham
• Alicia Pendleton
• Erica Penko, BCBA
• Danica Pennington
• Pamela R Pennington, PHD

• Ophthalmic Plastic and Reconstructive Surgery Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.