Fairbanks Ocular Prosthetics, Inc.

Primary specialty

OcularistTaxonomy code 156FX1700X

License

05-311-11 Issued in TN

Legal business name

FAIRBANKS OCULAR PROSTHETICS, INC.

Practice address

1720 West End Ave
Suite 402
Nashville, TN 37203

Phone

(615) 322-9940

Fax

(615) 320-0970

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stephen E Sanders, B.C.O., BADO

Title

President

Phone

(615) 322-9940

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700816949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WEST END AVE",
            "address_2": "SUITE 402",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-322-9940",
            "fax_number": "615-320-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 WEST END AVE",
            "address_2": "SUITE 402",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-322-9940",
            "fax_number": "615-320-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS OCULAR PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-322-9940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.C.O., BADO"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": "TN",
            "license": "05-311-11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452191",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90262916",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Fain, M.D.
• Graham P Fain, DO
• Michelle Joy Baylon Faina, PA
• Chelsea Fair
• Patrick Fair
• Kelly Fairbanks, APN
• Erin Leann Fairbrother, M.D.
• Samuel Walton Fairbrother
• Morgan Emily Faircloth
• Ronald B Fairs

• Technician/Technologist in Nashville, TN
• Providers in Nashville, TN by specialty
• Technician/Technologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.