Associates in Eye Care, Inc.
Organization Active NPI Optometrist · Oneida, TN
NPI 1679664304 · NPPES record last updated Mar 22, 2021
Key facts
- NPI
- 1679664304
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ASSOCIATES IN EYE CARE, INC.
- Practice address
- 16605 Alberta Road
Oneida, TN 37841-2515 - Phone
- (423) 569-9339
- Fax
- (423) 569-1316
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Gary Walter Upchurch, OD
- Title
- President and Authorized Official
- Phone
- (606) 387-5612
Other NPIs on the same Medicare enrollment 2
Practitioners 4
-
Kevin A Mysliwiec, O.D.
-
Matthew Testa, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040521000296 | TN | Part B Supplier - Clinic/Group Practice | 7012908643 |
Receives reassigned benefits from 8 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jacksboro, TN; Jellico, TN; Oneida, TN |
National Provider Directory
Locations
467 Sunset Trl
Jellico, TN 37762
Phone (423) 784-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TN | Yes |
Addresses
Primary practice location
16605 Alberta Road
Oneida, TN 37841-2515
Mailing address
PO Box 306
Ferguson, KY 42533-0306
Phone (606) 492-2211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3941367; 3941363 | Other | TN | MEDICAID # FOR DR. KEVIN MYSLIWIEC |
| 3946965 | Other | TN | MEDICARE PIN FOR DR. LINDSAY MCKINLEY |
| CJ5379 | Other | TN | RAILROAD MEDICARE |
| 3946891; 3946892 | Other | TN | MEDICARE PIN FOR DR. STEPHEN MCKINLEY |
| 3941348 | Medicaid | TN | |
| CP0230:011 | Other | EYEMED | |
| 3941367 | Other | TN | MEDICARE PIN FOR DR. KEVIN MYSLIWIEC |
| 3946891; 3946892 | Other | TN | MEDICAID # FOR DR. STEPHEN MCKINLEY |
| 62080 | Other | OPTUMHEALTH VISION | |
| 174791; 410981 | Other | TN | BCBSTN/BLUECARE/TENNCARE |
| 3946965 | Other | TN | MEDICAID # FOR DR. LINDSAY MCKINLEY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | COMPULINK | Health Information Exchange (HIE) |
Other providers in Oneida, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.