Ellen Owen Elmore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3100 Issued in TN

Practice address

1492 Madison St
Clarksville, TN 37040-8625

Phone

(931) 648-0544

Fax

(931) 648-3625

NPI assigned

Jun 13, 2013

Last updated

Jun 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Care of Clarksville PLLCGroup PAC ID 9739209008, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eelmore@familyeyecareclarksville.eyefinity-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Eye Care of Clarksville PLLC

  • Optometrist
  • Clarksville, TN
  • NPI 1083819668
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1245678028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408625",
            "telephone_number": "931-648-0544",
            "fax_number": "931-648-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408625",
            "telephone_number": "931-648-0544",
            "fax_number": "931-648-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "ELLEN",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall E Ellis, M.D.
• Roger Terry Ellis, D.D.S.
• Sarah Eisen Ellis, MD
• Angela Mae Ellison, APRN
• Terri Lynn Ellison, MSOT
• Grayson Hunter Elmore, ATC
• Jennifer Elrod, RBT
• Lisa M Ely, O.D.08
• Thomas Lee Ely, D.O.
• Paschal Nnamdi Emelue, MD

• Optometrist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.