Organization Active NPI

Mabry Eye Center PLLC

  • Ophthalmology Physician
  • Chattanooga, TN
National Provider Identifier
1659407070
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MABRY EYE CENTER PLLC
Practice address
1210 Premier Dr
Suite #110
Chattanooga, TN 37421-3747
Phone
(423) 385-2020
Fax
(423) 385-2021
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Dr. Elizabeth D. Mabry, M.D.
Title
Owner
Phone
(423) 385-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X TN Primary

Addresses

Primary practice location

1210 Premier Dr
Suite #110
Chattanooga, TN 37421-3747

Mailing address

1210 Premier Dr
Suite #110
Chattanooga, TN 37421-3747
Phone (423) 385-2020

Other identifiers 1

IdentifierTypeStateIssuer
3735912MedicaidTN

National Provider Directory

National Provider Directory

Locations

1210 Premier Dr
Ste 110
Chattanooga, TN 37421
Phone (423) 265-1651

1042 E 3rd St
Ste 102
Chattanooga, TN 37403
Phone (423) 265-1651

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1659407070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 PREMIER DR",
            "address_2": "SUITE #110",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213747",
            "telephone_number": "423-385-2020",
            "fax_number": "423-385-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 PREMIER DR",
            "address_2": "SUITE #110",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213747",
            "telephone_number": "423-385-2020",
            "fax_number": "423-385-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABRY EYE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "MABRY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-385-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735912",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.