Individual provider Active NPI

Frank L Oglesby Jr., O.D.

  • Optometrist
  • Kingsport, TN
National Provider Identifier
1275544041
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD900 Issued in TN
Practice address
1599 Fort Henry Dr
Suite 101
Kingsport, TN 37664-2535
Phone
(423) 246-2381
Fax
(423) 246-2301
NPI assigned
Aug 10, 2006
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD900 TN Primary

Addresses

Primary practice location

1599 Fort Henry Dr
Suite 101
Kingsport, TN 37664-2535

Mailing address

1599 Fort Henry Dr
Suite 101
Kingsport, TN 37664-2535
Phone (423) 246-2381

Other identifiers 1

IdentifierTypeStateIssuer
010274648MedicaidVA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111031000559 TN Practitioner - Optometry 3779756168 Practice locations: Kingsport, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1599 Ft Henry Dr
Suite 101
Kingsport, TN 37664-2535
Phone (423) 246-2381

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD900TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1275544041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 FORT HENRY DR",
            "address_2": "SUITE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642535",
            "telephone_number": "423-246-2381",
            "fax_number": "423-246-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 FORT HENRY DR",
            "address_2": "SUITE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642535",
            "telephone_number": "423-246-2381",
            "fax_number": "423-246-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "FRANK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010274648",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.