Larry Michael Chism, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

02774TG Issued in TX

Practice address

136 Shelley Dr
Tyler, TX 75701-8723

Phone

(903) 561-8686

Fax

(906) 581-1518

NPI assigned

Feb 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Houston - College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abc EyecareGroup PAC ID 0547619918, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Abc Eyecare

  dba Vision Source of Tyler

  • Optometrist
  • Tyler, TX
  • NPI 1255021432
  Medicare reassignment Care Compare group NPD
• Larry M Chism PC

  dba Vision Source of Tyler

  • Optometrist
  • Tyler, TX
  • NPI 1033247598
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376670216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHELLEY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018723",
            "telephone_number": "903-561-8686",
            "fax_number": "906-581-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SHELLEY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018723",
            "telephone_number": "903-561-8686",
            "fax_number": "906-581-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISM",
        "first_name": "LARRY",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "02774TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "48849",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "81381Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "552688",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "909986",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "08379",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA MEDICARE",
            "identifier": "0390950001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Elizabeth Childers, D.C.
• Victoria Paige Childers, MSN, FNP-C
• Children's Advocacy Center of Smith County
• Jessica Lynne Childress, APRN, FNP
• Chip Swinney DDS PA
• Shilpa Chitnis, MD
• Cassi Chitty
• Paul Blake Chlapek, PA
• Dennis Dale Choate II, DPT
• Keisha Choate

• Optometrist in Tyler, TX
• Providers in Tyler, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.