Midtown Eye Care PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

T1747 Issued in TN

Legal business name

MIDTOWN EYE CARE PLLC

Practice address

1378 Union Ave
Memphis, TN 38104-3623

Phone

(901) 725-3937

Fax

(901) 274-2342

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jared Thomas Powelson, ODNPI 1992798185

Title

Owner

Phone

(901) 725-3937

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Midtown Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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

• Jared Thomas Powelson, OD

  • Optometrist
  • Memphis, TN
  • NPI 1992798185
  Medicare reassignment Care Compare group NPD Authorized official
• Michael D Gerstner, OD

  • Optometrist
  • Memphis, TN
  • NPI 1215920350
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1508855859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043623",
            "telephone_number": "901-725-3937",
            "fax_number": "901-274-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043623",
            "telephone_number": "901-725-3937",
            "fax_number": "901-274-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "POWELSON",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-725-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "T1747",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "679",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "TPA94195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3717192",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Midtown Counseling Ctr
• Midtown Injury & Physical Therapy Center P.C.
• Midtown Medical Transport , LLC
• Midtown Mental Center
• Midtown Mental Health Center
• Midtown Mental Health Center

• 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 May 3, 2023; 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.