Advanced Eye Care Group, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1757 Issued in TN

Legal business name

ADVANCED EYE CARE GROUP, PLLC

Practice address

499 E. Winchester Blvd.
Suite 101
Collierville, TN 38017

Phone

(901) 850-2366

Fax

(901) 850-2367

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Koester, ODNPI 1215920152

Title

Optometrist

Phone

(901) 850-2366

Specialties & licenses 1

Addresses

Other names 1

• Advanced Eyecare & Optical Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Hatley Koester, O.D.

  • Optometrist
  • Collierville, TN
  • NPI 1215920152
  Medicare reassignment Care Compare group NPD Authorized official
• Brenta Medley, O.D.

  • Optometrist
  • Collierville, TN
  • NPI 1639162688
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1386701845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 E. WINCHESTER BLVD.",
            "address_2": "SUITE 101",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "38017",
            "telephone_number": "901-850-2366",
            "fax_number": "901-850-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 E. WINCHESTER BLVD.",
            "address_2": "SUITE 101",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "38017",
            "telephone_number": "901-850-2366",
            "fax_number": "901-850-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYE CARE GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "KOESTER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "901-850-2366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyecare & Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aegis Group Practice LLC

• All providers in Collierville, TN
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.