NPIMap

Organization Active NPI

East Memphis Eye Associates PLLC

Doing business as Eye Society

  • Optometrist
  • Germantown, TN
National Provider Identifier
1386092682
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN2254 Issued in TN
Legal business name
EAST MEMPHIS EYE ASSOCIATES PLLC
Doing business as
Eye Society
Practice address
9031 Valley Crest LN
Germantown, TN 38138-7829
Phone
(901) 757-2020
Fax
(901) 751-2399
NPI assigned
May 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Dr. Paul Darwin Mormon, ODNPI 1699768887
Title
Owner/Optometrist
Phone
(901) 757-2020

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X TN2254 TN Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X TN3251 TN
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X TN3230 TN

Addresses

Primary practice location

9031 Valley Crest LN
Germantown, TN 38138-7829

Mailing address

9031 Valley Crest LN
Germantown, TN 38138-7829
Phone (901) 757-2020

Other names 1

  • Eye Society Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200722001292 TN Part B Supplier - Clinic/Group Practice 6103240288 Receives reassigned benefits from 5 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

9031 Valley Crest Ln
Germantown, TN 38138
Phone (901) 262-9475

6450 Poplar Ave
Ste 117
Memphis, TN 38119
Phone (901) 797-9008

Practitioners & affiliated clinicians

Practitioners 6

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": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1386092682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 VALLEY CREST LN",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387829",
            "telephone_number": "901-757-2020",
            "fax_number": "901-751-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 VALLEY CREST LN",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387829",
            "telephone_number": "901-757-2020",
            "fax_number": "901-751-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MEMPHIS EYE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "MORMON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DARWIN",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "901-757-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN2254",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN3251",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN3230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Society",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Society",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.