Organization Active NPI

Eyecare Associates, P.C.

  • Optometrist
  • Hixson, TN
National Provider Identifier
1669669107
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD817 Issued in TN
Legal business name
EYECARE ASSOCIATES, P.C.
Practice address
4511 Hixson Pike
Hixson, TN 37343-5067
Phone
(423) 870-3742
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Mrs. Stacy Lynn West
Title
Office Manager
Phone
(423) 870-3742

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OD1190 TN
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X OD817 TN Primary

Addresses

Primary practice location

4511 Hixson Pike
Hixson, TN 37343-5067

Mailing address

4511 Hixson Pike
Hixson, TN 37343-5067
Phone (423) 870-3742

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930002269 TN DME Supplier - Physician - Optometrist 3072632397 Practice locations: Hixson, TN
O20101122000097 TN Part B Supplier - Clinic/Group Practice 3072632397 Receives reassigned benefits from 3 practitioners
Practice locations: Chattanooga, 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyecare Associates PC4511 Hixson Pike, Hixson, TN 37343-5035(423) 870-3742 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

725 Glenwood Dr
Ste E892
Chattanooga, TN 37404
Phone (423) 624-3937

725 Glenwood Dr
Ste 829E
Chattanooga, TN 37404
Phone (423) 624-3937

4511 Hixson Pike
Hixson, TN 37343
Phone (423) 624-3937

Practitioners & affiliated clinicians

Practitioners 5

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": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1669669107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 HIXSON PIKE",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435067",
            "telephone_number": "423-870-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 HIXSON PIKE",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435067",
            "telephone_number": "423-870-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-870-3742",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD1190",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.