Mia Samantha Taylor, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD0000003792 Issued in TN

Practice address

1932 Alcoa Hwy Ste 255
Knoxville, TN 37920-1508

Phone

(865) 244-2020

Fax

(865) 410-7292

NPI assigned

Jun 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Mia Samantha Kesler Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Southern College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Eye Specialists, P.C.Group PAC ID 0941278709, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtaylor@universityeye.direct.eyemdemr.com

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.

• University Eye Specialists, PC

  • Ophthalmology Physician
  • Knoxville, TN
  • NPI 1316916158
  Medicare reassignment Care Compare group NPD
• University Eye Surgeons, P.C.

  • Eyewear Supplier
  • Knoxville, TN
  • NPI 1598772964
  NPD

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1497487102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY STE 255",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201508",
            "telephone_number": "865-244-2030",
            "fax_number": "865-410-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 ALCOA HWY STE 255",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201508",
            "telephone_number": "865-244-2020",
            "fax_number": "865-410-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MIA",
        "middle_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2292DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000003792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "KESLER",
            "middle_name": "SAMANTHA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kala Taylor, PHD, LP-HSP
• Leslie Lynette Taylor, PTA
• Lisa Taylor
• Marisa S Taylor, MS, RD, LDN, CNSD
• McKenna Payton Taylor
• Nathaniel Taylor, BA
• Nicole Elizabeth Taylor, PMHNP-BC
• Rachel Taylor, CPNP
• Robert Earl Taylor, M.D.
• Ryan Zachary Taylor

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.