Individual provider Active NPI

Paula Putman Murray, OD

  • Optometrist
  • Clarksville, TN
National Provider Identifier
1386668705
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1758 Issued in TN
Practice address
621 N Riverside Dr
Clarksville, TN 37040-3147
Phone
(931) 647-5237
Fax
(270) 265-0013
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1758 TN Primary

Addresses

Primary practice location

621 N Riverside Dr
Clarksville, TN 37040-3147

Mailing address

621 N Riverside Dr
Clarksville, TN 37040-3127
Phone (270) 265-9036

Other identifiers 2

IdentifierTypeStateIssuer
77013621MedicaidKY
1881711786OtherGROUP NPI

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
I20210204002528 TN Practitioner - Optometry 8224054796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sites Vision ClinicGroup PAC ID 8123209061, 2 clinicians

Practice addresses (Care Compare)

621 N Riverside Dr
Clarksville, TN 37040-3127
Phone (931) 647-5237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1362KYMDMental Health Counselor
1758TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sites Vision Clinic Optometrist CurrentSince Nov 3, 2020 Accepting new patients

Locations

81 Public Sq
Elkton, KY 42220
Phone (270) 265-9036

621 N Riverside Dr
Clarksville, TN 37040
Phone (931) 647-5237

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1386668705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N RIVERSIDE DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403127",
            "telephone_number": "270-265-9036",
            "fax_number": "270-265-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N RIVERSIDE DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403147",
            "telephone_number": "931-647-5237",
            "fax_number": "270-265-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "PAULA",
        "middle_name": "PUTMAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013621",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1881711786",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.