Sullins Eye Care Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-761-TA-167 Issued in AL

Legal business name

SULLINS EYE CARE CENTER, INC.

Practice address

104 Gin Oaks CT
Madison, AL 35758-1736

Phone

(256) 464-6670

Fax

(256) 464-6670

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Lynne Tidwell

Title

Business Manager

Phone

(256) 464-6670

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Sullins Eye Care Center, Inc.

  • Optometrist
  • Huntsville, AL
  • NPI 1194909721

  O20050202000191

  Same enrollment

Locations

Practitioners 3

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

• Steve Luttrell Sullins, O.D.

  • Optometrist
  • Madison, AL
  • NPI 1740280205
  NPD
• Linda Anderson Jones, O.D.

  • Optometrist
  • Huntsville, AL
  • NPI 1578600425
  NPD (past)
• Theresa Paige Kennedy, O.D.

  • Optometrist
  • Madison, AL
  • NPI 1568571115
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1578744868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GIN OAKS CT",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581736",
            "telephone_number": "256-464-6670",
            "fax_number": "256-464-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GIN OAKS CT",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581736",
            "telephone_number": "256-464-6670",
            "fax_number": "256-464-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLINS EYE CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "256-464-6670"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-761-TA-167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "K232",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA GROUP PIN",
            "identifier": "Q949",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP PIN",
            "identifier": "529923030",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy W Strickland, M.A., L.P.C.
• Amber Stricklin, LICSW
• Stronger Together Relationship Counseling, LLC
• Jennifer Strother, CFN
• William Ray Stroud III, MD
• Steve Luttrell Sullins, O.D.
• Sullivan Medical, LLC
• Alicia Monique Sullivan-Smith, LMHC
• Rachel Renay Sullivan
• Veronica Harkness Sullivan, PMHNP-BC, DNP

• Optometrist in Madison, AL
• Providers in Madison, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.