Organization Active NPI

Tennessee Valley Vision PLLC

  • Optometrist
  • Lexington, TN
National Provider Identifier
1669228334
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TENNESSEE VALLEY VISION PLLC
Practice address
547 W Church St
Lexington, TN 38351-1703
Phone
(731) 249-1500
NPI assigned
Apr 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Dr. Jared L Cooper, ODNPI 1346498367
Title
Optometrist
Phone
(731) 213-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

547 W Church St
Lexington, TN 38351-1703

Mailing address

547 W Church St
Lexington, TN 38351-1703
Phone (731) 249-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241230000749 TN Part B Supplier - Clinic/Group Practice 6103353354 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1669228334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 W CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383511703",
            "telephone_number": "731-249-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 W CHURCH ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383511703",
            "telephone_number": "731-249-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VALLEY VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "731-213-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.