Kathleen Brianne Tariq, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1040 Issued in MS

Practice address

1431 W 10TH St Ste 5
Laurel, MS 39440-2626

Phone

(601) 649-1437

Fax

(601) 649-1431

NPI assigned

Jul 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Brianne Tanner Former name

Medicare fee-for-service enrollment

Enrolled in MS

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care AssociatesGroup PAC ID 5395761910, 5 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 and National Provider Directory roles.

• Eye Care Associates

  • Optometrist
  • Laurel, MS
  • NPI 1104039312
  Medicare reassignment Care Compare group NPD
• Eye Care Associates

  • Eyewear Supplier
  • Waynesboro, MS
  • NPI 1811125925
  NPD

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1437670080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 W 10TH ST STE 5",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402626",
            "telephone_number": "601-649-1437",
            "fax_number": "601-649-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 W 10TH ST STE 5",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402626",
            "telephone_number": "601-649-1437",
            "fax_number": "601-649-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "KATHLEEN",
        "middle_name": "BRIANNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "1040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "TANNER",
            "middle_name": "BRIANNE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April Swancey
• Muneeba Syed, M.D.
• Umer Talal
• Aremmia D. Tanious, M.D.
• George Lester Tarbutton, MD, MPH
• Rayhan A. Tariq, M.D.
• Amaya G Tavarez, LPN
• Makinley Taylor
• TD Angel Homecare LLC (TD Mobile Lab & Specimen)
• Karen Sue Temple, CFNP

• Optometrist in Laurel, MS
• Providers in Laurel, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.