Organization Active NPI

Mountain Empire Cataract & Eye Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bristol, TN
National Provider Identifier
1245340603
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
152 Issued in TN
Legal business name
MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER
Practice address
3185 W State St
Suite 2020
Bristol, TN 37620-1610
Phone
(423) 968-4141
Fax
(423) 968-7641
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Amy Burton
Title
Director Credentialing
Phone
(434) 661-7762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 152 TN Primary

Addresses

Primary practice location

3185 W State St
Suite 2020
Bristol, TN 37620-1610

Mailing address

2010 Bremo Rd Ste 128a
Richmond, VA 23226-2444
Phone (877) 969-0392

Other identifiers 5

IdentifierTypeStateIssuer
P00056474OtherTNRAILROAD MEDICARE
TN0101OtherTNJOHN DEERE HEALTH CARE
010024676MedicaidVA
4068468OtherTNBLUE CROSS BLUE SHIELD
019997OtherVAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000683 TN Part B Supplier - Ambulatory Surgical Center 9830003110 Practice locations: Bristol, TN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Mountain Empire Cataract and Eye Surgery CenterCCN 44C0001129
Medicare certification status
ActiveFrom the Provider of Services file

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1009070Mountain Empire Cataract & Eye Surgery Center3185 W State Street Ste 2020, Bristol, TN 37620Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1245340603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BREMO RD STE 128A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262444",
            "telephone_number": "877-969-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 W STATE ST",
            "address_2": "SUITE 2020",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201610",
            "telephone_number": "423-968-4141",
            "fax_number": "423-968-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING",
        "authorized_official_telephone_number": "434-661-7762"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00056474",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH CARE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010024676",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4068468",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "019997",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.