NPIMap

Organization Active NPI

Eyecare Plus Ca,PLLC

  • Optometrist
  • Columbia, TN
National Provider Identifier
1790732519
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN1920 Issued in TN
Legal business name
EYECARE PLUS CA,PLLC
Practice address
816 S James Campbell Blvd
Columbia, TN 38401-4338
Phone
(931) 540-2445
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Cheyanne Mullis
Title
Credentailing Manager
Phone
(615) 988-5303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X TN1920 TN Primary

Addresses

Primary practice location

816 S James Campbell Blvd
Columbia, TN 38401-4338

Mailing address

816 S James Campbell Blvd
Columbia, TN 38401-4338
Phone (931) 540-2445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000713 TN Part B Supplier - Clinic/Group Practice 3072427368 Receives reassigned benefits from 14 practitioners
Practice locations: Columbia, TN

National Provider Directory

National Provider Directory

Locations

816 S James M Campbell Blvd
Columbia, TN 38401
Phone (931) 540-0700

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1790732519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S JAMES CAMPBELL BLVD",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014338",
            "telephone_number": "931-540-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S JAMES CAMPBELL BLVD",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014338",
            "telephone_number": "931-540-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PLUS CA,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "MULLIS",
        "authorized_official_first_name": "CHEYANNE",
        "authorized_official_title_or_position": "CREDENTAILING MANAGER",
        "authorized_official_telephone_number": "615-988-5303"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN1920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.