Active NPI
Calvert Opthalmology PSC
- Ophthalmology Physician
- Clarksville, TN
National Provider Identifier
1326210451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD0000035976
- Legal business name
- CALVERT OPTHALMOLOGY PSC
- Practice address
- 290 Clear Sky Court
Clarksville, TN 37043 - Phone
- (931) 647-4900
- Fax
- (931) 647-1333
- NPI assigned
- Mar 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Harold Milton Calvert
- Title
- President/MD
- Phone
- (270) 886-2050
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD0000035976 | TN | Primary |
Addresses
Primary practice location
290 Clear Sky Court
Clarksville, TN 37043
Mailing address
100 Keeton Drive
Hopkinsville, KY 42240-8756
Phone (270) 886-2050
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3704121 | Medicaid | TN | |
| 4061554 | Other | TN | BLUECROSS GROUP |
| 01035351 | Other | TN | TN AMERIGROUP |
| 180045298 | Other | TN | RAILROAD MEDICARE |
Other names 1
- CALVERT OPHTHALMOLOGY CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090729000648 | TN | Part B Supplier - Clinic/Group Practice | 5193740959 |
Receives reassigned benefits from 12 practitioners Practice locations: Clarksville, TN; Franklin, TN |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Calvert Ophthalmology Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Hopkinsville, KY
- NPI 1508036831
Locations
2625 Scottsville Rd
Ste 324
Bowling Green, KY 42104
Phone (270) 846-0131
100 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 886-2050
Practitioners & affiliated clinicians
Practitioners 12
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": "1206662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1593993600000",
"number": "1326210451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KEETON DRIVE",
"city": "HOPKINSVILLE",
"state": "KY",
"postal_code": "422408756",
"telephone_number": "270-886-2050",
"fax_number": "270-886-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 CLEAR SKY COURT",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "37043",
"telephone_number": "931-647-4900",
"fax_number": "931-647-1333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CALVERT OPTHALMOLOGY PSC",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-28",
"last_updated": "2020-07-06",
"certification_date": "2020-07-06",
"status": "A",
"authorized_official_last_name": "CALVERT",
"authorized_official_first_name": "HAROLD",
"authorized_official_middle_name": "MILTON",
"authorized_official_title_or_position": "PRESIDENT/MD",
"authorized_official_telephone_number": "270-886-2050"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "TN",
"license": "MD0000035976",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3704121",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS GROUP",
"identifier": "4061554",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TN AMERIGROUP",
"identifier": "01035351",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180045298",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CALVERT OPHTHALMOLOGY CENTER",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CALVERT OPHTHALMOLOGY CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}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 Jul 6, 2020; 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.