Organization Active NPI

Passons Eye Center, P.L.L.C.

  • Ophthalmology Physician
  • Memphis, TN
National Provider Identifier
1720264468
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD12831 Issued in TN
Legal business name
PASSONS EYE CENTER, P.L.L.C.
Practice address
909 Ridgeway Loop Rd
Memphis, TN 38120-4016
Phone
(901) 683-1112
Fax
(901) 683-1174
NPI assigned
Jan 11, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Dr. Gary A. Passons, MDNPI 1689784985
Title
Owner
Phone
(901) 683-1112

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)CodeLicenseStatePrimary
Optometrist 152W00000X TNOD641T TN
Ophthalmology Physician 207W00000X MD36450 TN
Ophthalmology Physician 207W00000X MD43481 TN
Ophthalmology Physician 207W00000X MD12831 TN Primary

Addresses

Primary practice location

909 Ridgeway Loop Rd
Memphis, TN 38120-4016

Mailing address

909 Ridgeway Loop Rd
Memphis, TN 38120-4016
Phone (901) 683-1112

Other identifiers 2

IdentifierTypeStateIssuer
4176557OtherTNBLUE CROSS BLUE SHIELD OF TENNESSEE
30235062MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081119000403 TN Part B Supplier - Clinic/Group Practice 1052494788 Receives reassigned benefits from 4 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

909 Ridgeway Loop Rd
Memphis, TN 38120
Phone (901) 683-1112

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1720264468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIDGEWAY LOOP RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204016",
            "telephone_number": "901-683-1112",
            "fax_number": "901-683-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 RIDGEWAY LOOP RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204016",
            "telephone_number": "901-683-1112",
            "fax_number": "901-683-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSONS EYE CENTER, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "PASSONS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-683-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TNOD641T",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD36450",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD43481",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD12831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
            "identifier": "4176557",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30235062",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.