Organization Active NPI

Sites Vision Clinic

  • Optometrist
  • Clarksville, TN
National Provider Identifier
1235256512
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT1759 Issued in TN
Legal business name
SITES VISION CLINIC
Practice address
621 N Riverside Dr
Clarksville, TN 37040-3127
Phone
(931) 647-5237
Fax
(931) 647-5254
NPI assigned
Mar 23, 2007
Last updated
May 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Authorized official

Name
Dr. Brian Roy Murray, OPTOMETRISTNPI 1821002650
Title
Co-Owner
Phone
(931) 647-5237

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT1759 TN Primary

Addresses

Primary practice location

621 N Riverside Dr
Clarksville, TN 37040-3127

Mailing address

621 N Riverside Dr
Clarksville, TN 37040-3127
Phone (931) 647-5237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110224000616 TN DME Supplier - Physician - Optometrist 8123209061 Practice locations: Clarksville, TN
O20110426000208 TN Part B Supplier - Clinic/Group Practice 8123209061 Receives reassigned benefits from 2 practitioners
Practice locations: Clarksville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sites Vision Clinic621 N Riverside Dr, Clarksville, TN 37040-3147(931) 647-5237 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Feb 26, 2011

National Provider Directory

National Provider Directory

Locations

621 N Riverside Dr
Clarksville, TN 37040
Phone (931) 647-5237

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1235256512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N RIVERSIDE DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403127",
            "telephone_number": "931-647-5237",
            "fax_number": "931-647-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N RIVERSIDE DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403127",
            "telephone_number": "931-647-5237",
            "fax_number": "931-647-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SITES VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "931-647-5237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.