Organization Active NPI

Mark a. Bowers

Doing business as Blountville Family Eyecare

  • Optometrist
  • Blountville, TN
National Provider Identifier
1497279442
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2336 Issued in TN
Legal business name
MARK A. BOWERS
Doing business as
Blountville Family Eyecare
Practice address
2554 Highway 394
Blountville, TN 37617
Phone
(423) 323-3799
Fax
(423) 323-3752
NPI assigned
Aug 1, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Christy K Sharpe
Title
Office Manager
Phone
(423) 323-3799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2336 TN Primary

Addresses

Primary practice location

2554 Highway 394
Blountville, TN 37617

Mailing address

2554 Highway 394
Blountville, TN 37617-4133
Phone (423) 323-3799

Other identifiers 1

IdentifierTypeStateIssuer
4087308OtherTNBLUE CROSS PROVIDER NUMBER

Other names 1

  • Blountville Family Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181105000782 TN Part B Supplier - Clinic/Group Practice 0840479457 Receives reassigned benefits from 3 practitioners
Practice locations: Blountville, TN

National Provider Directory

National Provider Directory

Locations

1323 Highway 394
Ste B
Blountville, TN 37617
Phone (423) 323-3799

2554 Highway 394
Blountville, TN 37617
Phone (423) 323-3799

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497279442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 HIGHWAY 394",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376174133",
            "telephone_number": "423-323-3799",
            "fax_number": "423-323-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 HIGHWAY 394",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "37617",
            "telephone_number": "423-323-3799",
            "fax_number": "423-323-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. BOWERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "SHARPE",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-323-3799"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBER",
            "identifier": "4087308",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blountville Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blountville Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blountville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.