Organization Active NPI

Mountain Empire Eye Physicians PLLC

  • Ophthalmology Physician
  • Bristol, TN
National Provider Identifier
1609969682
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MOUNTAIN EMPIRE EYE PHYSICIANS PLLC
Practice address
3185 West State Street
Suite 2010
Bristol, TN 37620
Phone
(423) 968-7555
Fax
(423) 968-7641
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Mr. Stacy F. Perdue, MBA
Title
Administrator
Phone
(423) 968-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3185 West State Street
Suite 2010
Bristol, TN 37620

Mailing address

2010 Bremo Rd Ste 128a
Richmond, VA 23226-2444
Phone (877) 969-0392

Other practice location 1

224 Clay Dr
Pounding Mill, VA 24637-4320
Phone (888) 857-5033

Other practice location 2

137 Plaza Rd
Wise, VA 24293-4613
Phone (800) 698-3019

Other practice location 3

1020 Terrace Dr Ste 100
Marion, VA 24354-4392
Phone (800) 698-3019

Other practice location 4

2308 Cedar Valley Dr
Cedar Bluff, VA 24609-9302
Phone (800) 698-3019

Other identifiers 2

IdentifierTypeStateIssuer
CG3621OtherGARAILROAD MEDICARE
CG3622OtherVARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040621000678 VA Part B Supplier - Clinic/Group Practice 3870578248 Receives reassigned benefits from 7 practitioners
Practice locations: Cedar Bluff, VA; Marion, VA; Pounding Mill, VA; Wise, VA
O20040721000074 TN Part B Supplier - Clinic/Group Practice 3870578248 Receives reassigned benefits from 5 practitioners
Practice locations: Bristol, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2314912Mountain Empire Eye Physicians3185 W State Street Ste 2010, Bristol, TN 37620Certificate of waiverDec 2, 2026

National Provider Directory

National Provider Directory

Locations

3183 W State St
Ste 1101
Bristol, TN 37620
Phone (423) 968-2772

2308 Cedar Valley Dr
Cedar Bluff, VA 24609
Phone (276) 963-9616

1020 Terrace Dr
Marion, VA 24354
Phone (276) 783-2511

1020 Terrace Dr
Ste 100
Marion, VA 24354
Phone (276) 783-5157

224 Clay Dr
Pounding Mill, VA 24637
Phone (229) 395-9181

135 Plaza Rd
Wise, VA 24293
Phone (540) 679-5612

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1609969682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BREMO RD STE 128A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262444",
            "telephone_number": "877-969-0392",
            "fax_number": "423-968-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 WEST STATE STREET",
            "address_2": "SUITE 2010",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-968-7555",
            "fax_number": "423-968-7641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Clay Dr",
            "address_purpose": "LOCATION",
            "city": "Pounding Mill",
            "state": "VA",
            "postal_code": "246374320",
            "country_code": "US",
            "telephone_number": "888-857-5033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 Plaza Rd",
            "address_purpose": "LOCATION",
            "city": "Wise",
            "state": "VA",
            "postal_code": "242934613",
            "country_code": "US",
            "telephone_number": "800-698-3019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 Terrace Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243544392",
            "country_code": "US",
            "telephone_number": "800-698-3019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2308 Cedar Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Cedar Bluff",
            "state": "VA",
            "postal_code": "246099302",
            "country_code": "US",
            "telephone_number": "800-698-3019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN EMPIRE EYE PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "PERDUE",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-968-7555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG3621",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG3622",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.