Individual provider Active NPI

C Wade Hyatt III

  • Optometrist
  • Nashville, TN
National Provider Identifier
1669467452
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1474T Issued in TN
Practice address
5505 Edmondson Pike
Suite 101
Nashville, TN 37211-5869
Phone
(615) 331-8688
Fax
(615) 331-2273
NPI assigned
Sep 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1474T TN Primary

Addresses

Primary practice location

5505 Edmondson Pike
Suite 101
Nashville, TN 37211-5869

Mailing address

5505 Edmondson Pike
Suite 101
Nashville, TN 37211-5872
Phone (615) 331-8688

Other identifiers 2

IdentifierTypeStateIssuer
41004420OtherTNRAILROAD MEDICARE/CHEATHAM CO EYECARE
410047740OtherTNRAILROAD MEDICARE/NASHVILLE EYE GRP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111019000440 TN Practitioner - Optometry 9032226311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Optometry Unlimited, LLCGroup PAC ID 7517170012, 4 clinicians

Practice addresses (Care Compare)

154 Hutton PL
Ashland City, TN 37015-4953
Phone (615) 792-4321

5429 Edmondson Pike
Nashville, TN 37211-5806
Phone (615) 331-8688

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1474TNMDMarriage & Family Therapist
1474TTNMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1669467452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 EDMONDSON PIKE",
            "address_2": "SUITE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115872",
            "telephone_number": "615-331-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 EDMONDSON PIKE",
            "address_2": "SUITE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115869",
            "telephone_number": "615-331-8688",
            "fax_number": "615-331-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT III",
        "first_name": "C WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-17",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1474T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/CHEATHAM CO EYECARE",
            "identifier": "41004420",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/NASHVILLE EYE GRP",
            "identifier": "410047740",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.