NPIMap

Organization Active NPI

Sunset Eye Care PC

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1265853253
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2796 Issued in TN
Legal business name
SUNSET EYE CARE PC
Practice address
302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408
Phone
(423) 282-1742
Fax
(423) 283-4924
NPI assigned
Dec 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Dr. Angela Patteson, ODNPI 1437112984
Title
Owner
Phone
(423) 282-1472

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2796 TN Primary

Addresses

Primary practice location

302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408

Mailing address

302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408
Phone (423) 282-1742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140421000551 TN Part B Supplier - Clinic/Group Practice 4082846332 Receives reassigned benefits from 3 practitioners
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Locations

302 Sunset Dr
Ste 109
Johnson City, TN 37604
Phone (423) 282-1742

Practitioners & affiliated clinicians

Practitioners 5

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": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1265853253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 SUNSET DR",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042408",
            "telephone_number": "423-282-1742",
            "fax_number": "423-283-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SUNSET DR",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042408",
            "telephone_number": "423-282-1742",
            "fax_number": "423-283-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "PATTESON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-282-1472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.