Active NPI
Associates in Eye Care, Inc.
- Optometrist
- Jellico, TN
National Provider Identifier
1427149160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- ASSOCIATES IN EYE CARE, INC.
- Practice address
- 467 Sunset Trail
Jellico, TN 37762-2709 - Phone
- (423) 784-2020
- Fax
- (423) 784-4940
- NPI assigned
- Sep 27, 2006
- Last updated
- Mar 22, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary Walter Upchurch, OD
- Title
- President and Authorized Official
- Phone
- (606) 387-5612
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TN | Primary |
Addresses
Primary practice location
467 Sunset Trail
Jellico, TN 37762-2709
Mailing address
127 Foothills Ave
Suite 3
Albany, KY 42602-1090
Phone (606) 387-5612
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3946892 | Medicaid | TN | |
| AO0136:001 | Other | EYEMED | |
| 4209308 | Other | TN | BLUECARE/TENNCARE/BCBSTN |
| 3946891; 3946892 | Other | TN | MEDICAID # FOR DR. STEPHEN MCKINLEY |
| 62079 | Other | OPTUMHEALTH VISION | |
| 3941346 | Medicaid | TN | |
| CJ5379 | Other | TN | RAILROAD MEDICARE |
| 3941098 | Other | TN | MEDICAID # FOR DR. ERIC TODD OVERLEY |
| 7100209950 | Medicaid | KY | |
| 174791 | Other | TN | BLUECARE/TENNCARE/BCBSTN--GROUP |
| 3941098 | Other | TN | MEDICARE PIN FOR DR. ERIC TODD OVERLEY |
| 3946891; 3946892 | Other | TN | MEDICARE PIN FOR DR. STEPHEN MCKINLEY |
| 4104981 | Other | TN | BLUECARE/TENNCARE/BCBSTN--GROUP |
| 77902641 | Medicaid | KY | |
| K217560 | Other | KY | MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | COMPULINK | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040521000296 | TN | Part B Supplier - Clinic/Group Practice | 7012908643 |
Receives reassigned benefits from 8 practitioners 3 other NPIs on this enrollment Practice locations: Jacksboro, TN; Jellico, TN; Oneida, TN |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
86 Medical Ln
Whitley City, KY 42653
Phone (606) 376-1551
16605 Alberta St
Oneida, TN 37841
Phone (423) 569-9339
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Optometrist
- Jacksboro, TN
- NPI 1760885800
-
- Optometrist
- Jacksboro, TN
- NPI 1275539736
-
- Optometrist
- Oneida, TN
- NPI 1013014539
-
- Optometrist
- Jacksboro, TN
- NPI 1285860841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616371200000",
"number": "1427149160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 FOOTHILLS AVE",
"address_2": "SUITE 3",
"city": "ALBANY",
"state": "KY",
"postal_code": "426021090",
"telephone_number": "606-387-5612",
"fax_number": "606-387-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 SUNSET TRAIL",
"city": "JELLICO",
"state": "TN",
"postal_code": "377622709",
"telephone_number": "423-784-2020",
"fax_number": "423-784-4940"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASSOCIATES IN EYE CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-27",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A",
"authorized_official_last_name": "UPCHURCH",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "WALTER",
"authorized_official_title_or_position": "PRESIDENT AND AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "606-387-5612",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3946892",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "AO0136:001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE/TENNCARE/BCBSTN",
"identifier": "4209308",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID # FOR DR. STEPHEN MCKINLEY",
"identifier": "3946891; 3946892",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUMHEALTH VISION",
"identifier": "62079",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3941346",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CJ5379",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID # FOR DR. ERIC TODD OVERLEY",
"identifier": "3941098",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100209950",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE/TENNCARE/BCBSTN--GROUP",
"identifier": "174791",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN FOR DR. ERIC TODD OVERLEY",
"identifier": "3941098",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN FOR DR. STEPHEN MCKINLEY",
"identifier": "3946891; 3946892",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE/TENNCARE/BCBSTN--GROUP",
"identifier": "4104981",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77902641",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "K217560",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "COMPULINK",
"affiliation": "N",
"endpointDescription": "SECURE SOFTWARE",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "ELECTRONIC HEALTH RECORDS",
"address_1": "467 Sunset Trail",
"city": "Jellico",
"state": "TN",
"country_code": "US",
"postal_code": "377622709",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jellico, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.