Dr. Mike M Sandy, Optometrist, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT2015 Issued in TN

Legal business name

DR. MIKE M SANDY, OPTOMETRIST, LLC

Practice address

3775 Hacks Cross Rd
Memphis, TN 38125-2302

Phone

(901) 214-0065

Fax

(901) 214-0066

NPI assigned

May 10, 2008

Last updated

May 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike M Sandy, OD

Title

Owner

Phone

(901) 219-3453

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210377600000",
    "number": "1699942573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 SHADY ELM DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380180437",
            "telephone_number": "901-219-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 HACKS CROSS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252302",
            "telephone_number": "901-214-0065",
            "fax_number": "901-214-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MIKE M SANDY, OPTOMETRIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-10",
        "last_updated": "2008-05-10",
        "status": "A",
        "authorized_official_last_name": "SANDY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-219-3453",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT2015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Memphis, TN
• Providers in Memphis, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.