Professional Eyecare Optical, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

098007728 Issued in TN

Legal business name

PROFESSIONAL EYECARE OPTICAL, PLLC

Practice address

428 Perkins Ext
Memphis, TN 38117

Phone

(901) 763-2020

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

DO Nguyen, ODNPI 1407114663

Title

President

Phone

(901) 763-2020

Specialties & licenses 1

Addresses

Other names 2

• Eyewear Gallery Doing business as
• Professional Eyecare Optical, P.C. Former legal business name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• DO Nguyen

  • Optometrist
  • Memphis, TN
  • NPI 1407114663
  Medicare reassignment NPD Authorized official
• Stephanie L Johnson, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1659825669
  Medicare reassignment NPD
• Ryan Livesay, OD

  • Optometrist
  • Memphis, TN
  • NPI 1871200238
  Medicare reassignment NPD

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1497946016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 PERKINS EXT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173802",
            "telephone_number": "901-763-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 PERKINS EXT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-763-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYECARE OPTICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-763-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "098007728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyewear Gallery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyewear Gallery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Eyecare Optical, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mary L Proctor, DOT
• Annette B Proenza, PHARM D
• Professional Audiological Services, Inc.
• Professional Audiological Services, Inc.
• Professional Eyecare Optical
• Grace Amelia Proffitt, DO
• Progressive Wound Care PLLC
• Prohealth Chiropractic LLC
• Lynnette K Prokop, PA
• Prominent Mobile Labs LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.