Individual provider Active NPI

Katherine Petrinjak Sullins, OD

  • Optometrist
  • Athens, TN
National Provider Identifier
1578453239
Registry record updated Jul 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3945 Issued in TN
Practice address
517 N Jackson St
Athens, TN 37303-3621
Phone
(423) 745-4910
Fax
(423) 745-2230
NPI assigned
Jul 5, 2025
Last updated
Jul 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3945 TN Primary

Addresses

Primary practice location

517 N Jackson St
Athens, TN 37303-3621

Mailing address

517 N Jackson St
Athens, TN 37303-3621
Phone (423) 745-4910

Other practice location 1

620 Englewood Rd
Madisonville, TN 37354-1218
Phone (423) 442-2806

Other names 1

  • Katherine Sloan Petrinjak Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250715002827 TN Practitioner - Optometry 8729593066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sullins Eye Care P.C.Group PAC ID 9436241304, 5 clinicians

Practice addresses (Care Compare)

517 N Jackson St
Athens, TN 37303-3621
Phone 4237454910312

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3945TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sullins Eye Care P.C. Optometrist Current Accepting new patients
Sullins Eye Care P.C. Optometrist CurrentSince Jul 7, 2025 Accepting new patients
Southeastern Retina Associates, P.C. PastSince Jul 7, 2025 Accepting new patients
Athens Eye Care Center, P.C. Optometrist Past Accepting new patients

Locations

517 N Jackson St
Athens, TN 37303
Phone (423) 745-4910

620 Englewood Rd
Madisonville, TN 37354
Phone (423) 442-2806

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1751673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751673600000",
    "number": "1578453239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N JACKSON ST",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373033621",
            "telephone_number": "423-745-4910",
            "fax_number": "423-745-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 N JACKSON ST",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373033621",
            "telephone_number": "423-745-4910",
            "fax_number": "423-745-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Englewood Rd",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "TN",
            "postal_code": "373541218",
            "country_code": "US",
            "telephone_number": "423-442-2806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLINS",
        "first_name": "KATHERINE",
        "middle_name": "PETRINJAK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-05",
        "last_updated": "2025-07-05",
        "certification_date": "2025-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "PETRINJAK",
            "middle_name": "SLOAN",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, TN

Sources for this page

Verify at the official NPI Registry.