Vision Source of Lewis County LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VISION SOURCE OF LEWIS COUNTY LLC

Practice address

617 W Main St
Hohenwald, TN 38462-1355

Phone

(615) 373-0080

NPI assigned

Jun 10, 2019

Last updated

Jun 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Young, ODNPI 1184619009

Title

Owner

Phone

(615) 373-0080

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth A Young, O.D.

  • Optometrist
  • Brentwood, TN
  • NPI 1184619009
  Authorized official Same address or phone

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1649839028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WARD CIR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277552",
            "telephone_number": "615-373-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 W MAIN ST",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384621355",
            "telephone_number": "615-373-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE OF LEWIS COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-373-0080",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara J Stoll, CPM-TN
• Melissa Irene Sullivan, PHARMD.
• Elizabeth Thompson, BS
• Top Flight Medical Group LLC
• Miranda Ulanowski, FNP-C
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1115)
• Wellness Family Dentistry
• Leona Dean White, LPN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.