Larry Lee Nicholson II OD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

LARRY LEE NICHOLSON II OD

Practice address

19870 Main St E
Huntingdon, TN 38344-3927

Phone

(731) 986-4400

Fax

(731) 986-7981

NPI assigned

Jun 12, 2006

Last updated

Oct 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Larry Lee Nicholson II OD, O.D.

Title

Owner Corporation President

Phone

(731) 986-4400

Specialties & licenses 1

Addresses

Other names 1

• Huntingdon Eye Care, PC Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• Larry Lee Nicholson II, O.D.

  • Optometrist
  • Huntingdon, TN
  • NPI 1053313338
  Medicare reassignment

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1477595783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19870 MAIN ST E",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383443927",
            "telephone_number": "731-986-4400",
            "fax_number": "731-986-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19870 MAIN ST E",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383443927",
            "telephone_number": "731-986-4400",
            "fax_number": "731-986-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY LEE NICHOLSON II OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON II OD",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "731-986-4400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntingdon Eye Care, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amber Kee, PTA
• Kathy G Kee, NP,RN,BSN
• Misty McRae King, P.T.
• Jill Marie Kirk, RN
• Jantzen Kirra Lambert, D.D.S.
• Lee Marvin Carter
• Malarie Brooke Leonard, PHARM.D.
• LHCG Xciv, LLC (Baptist Memorial Home Care & Hospice)
• LHCG Xcvi, LLC (Baptist Memorial Home Care & Hospice)
• Shearll Denece Lockhart, LPN

• Optometrist in Huntingdon, TN
• Providers in Huntingdon, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.