Active NPI
Enrique Carlos Palacios, O.D.
- Optometrist
- Bartlett, TN
National Provider Identifier
1730537069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3294
- Practice address
- 6344 Mercury CV
Bartlett, TN 38134-4669 - Phone
- (508) 410-1671
- NPI assigned
- May 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3294 | TN | Primary |
Addresses
Primary practice location
6344 Mercury CV
Bartlett, TN 38134-4669
Mailing address
6344 Mercury CV
Bartlett, TN 38134-4669
Phone (508) 410-1671
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3294 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1730537069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6344 MERCURY CV",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381344669",
"telephone_number": "508-410-1671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6344 MERCURY CV",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381344669",
"telephone_number": "508-410-1671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALACIOS",
"first_name": "ENRIQUE",
"middle_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-26",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "3294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartlett, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.