Premier Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TNOD1904 Issued in TN

Legal business name

PREMIER EYECARE, PLLC

Practice address

11121 Kingston Pike
Suite a
Knoxville, TN 37934-2890

Phone

(865) 966-0100

Fax

(865) 966-0007

NPI assigned

Jun 15, 2007

Last updated

Aug 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent B Fry, O.D.NPI 1154325819

Title

Owner

Phone

(865) 966-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drfry@premiereyecare2002.eyefinity-direct.com

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent B Fry, O.D.

  • Optometrist
  • Knoxville, TN
  • NPI 1154325819
  Medicare reassignment Care Compare group NPD Authorized official
• Taylor Nicole Greene, OD

  • Optometrist
  • Knoxville, TN
  • NPI 1154975324
  Medicare reassignment Care Compare group NPD
• William Richard Beaty, OD

  • Optometrist
  • Asheville, NC
  • NPI 1003539214

  TN

  Medicare reassignment Care Compare group
• Mary Nethaway Chase

  • Optometrist
  • Cleveland, TN
  • NPI 1487140232
  Medicare reassignment NPD

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1356546816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 KINGSTON PIKE",
            "address_2": "SUITE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342890",
            "telephone_number": "865-966-0100",
            "fax_number": "865-966-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11121 KINGSTON PIKE",
            "address_2": "SUITE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342890",
            "telephone_number": "865-966-0100",
            "fax_number": "865-966-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-966-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TNOD1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3945177",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preferred Care at Home
• Preferred Pain Care, LLC
• Sean Frederick Preiss, PT
• Premier Dental Group, PLLC of Knoxville
• Premier Eye Consultants, PLLC
• Premier Radiation Oncology Services, PC
• Premier Servants LLC (Visiting Angels Living Assistance Services)
• Premier Surgical Associates, PLLC
• Premier Surgical Associates, PLLC
• Premier Wound Care of Tennessee, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.