Active NPI
VRF Eye Specialty Group, PLC
- Ophthalmology Physician
- Memphis, TN
National Provider Identifier
1699729806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- VRF EYE SPECIALTY GROUP, PLC
- Practice address
- 825 Ridge Lake Blvd
Memphis, TN 38120-9411 - Phone
- (901) 685-2200
- Fax
- (901) 820-2342
- NPI assigned
- May 20, 2006
- Last updated
- May 19, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Subba Gollamudi, M.D.
- Title
- Chief Manager
- Phone
- (901) 685-2200
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Ophthalmology Physician | 207W00000X | Primary | ||
| Family Nurse Practitioner | 363LF0000X | |||
| Clinical Nurse Specialist | 364S00000X |
Addresses
Primary practice location
825 Ridge Lake Blvd
Memphis, TN 38120-9411
Mailing address
825 Ridge Lake Blvd
Memphis, TN 38120-9411
Phone (901) 685-2200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09015167 | Medicaid | MS | |
| 127952002 | Medicaid | AR | |
| 3383289 | Medicaid | TN | |
| 506916204 | Medicaid | MO |
Other names 1
- Vitreoretinal Foundation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MS, AR
Enrollment records 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0314811 | VRF Eye Specialty Group PLC | Certificate of waiver | Apr 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
1000 Windover Rd
Ste C
Jonesboro, AR 72401
Phone (870) 972-6040
325C N Sebastian
West Helena, AR 72390
Phone (870) 572-7886
207B Highway 641 N
Camden, TN 38320
Phone (731) 584-7942
5406 Knight Arnold Rd
Memphis, TN 38115
Phone (901) 359-8081
825 Ridge Lake Blvd
#1194
Memphis, TN 38120
Practitioners & affiliated clinicians
Practitioners 24
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Memphis, TN
- NPI 1215977871
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589846400000",
"number": "1699729806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 RIDGE LAKE BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381209411",
"telephone_number": "901-685-2200",
"fax_number": "901-820-2342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 RIDGE LAKE BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381209411",
"telephone_number": "901-685-2200",
"fax_number": "901-820-2342"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VRF EYE SPECIALTY GROUP, PLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-20",
"last_updated": "2020-05-19",
"certification_date": "2020-05-19",
"status": "A",
"authorized_official_last_name": "GOLLAMUDI",
"authorized_official_first_name": "SUBBA",
"authorized_official_title_or_position": "CHIEF MANAGER",
"authorized_official_telephone_number": "901-685-2200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "364S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09015167",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "127952002",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3383289",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "506916204",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Vitreoretinal Foundation",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Vitreoretinal Foundation",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.