Active NPI
Mark Bruce Givens, OD
- Optometrist
- Clarksville, TN
National Provider Identifier
1750482659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 499
- Practice address
- 2801 Wilma Rudolph Blvd
Suite #100
Clarksville, TN 37040-5011 - Phone
- (931) 553-2132
- Fax
- (931) 552-7446
- NPI assigned
- Sep 26, 2006
- 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 | 499 | TN | Primary |
Addresses
Primary practice location
2801 Wilma Rudolph Blvd
Suite #100
Clarksville, TN 37040-5011
Mailing address
PO Box 110567
Nashville, TN 37222-0567
Phone (931) 553-2132
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 499 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319328000000",
"number": "1750482659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110567",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372220567",
"telephone_number": "931-553-2132",
"fax_number": "931-552-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 WILMA RUDOLPH BLVD",
"address_2": "SUITE #100",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405011",
"telephone_number": "931-553-2132",
"fax_number": "931-552-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIVENS",
"first_name": "MARK",
"middle_name": "BRUCE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2011-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.