NPIMap

Eye Centers of Tennessee, LLC

Organization Active NPI Optometrist · Pikeville, TN

NPI 1801474168 · NPPES record last updated Mar 30, 2021

Key facts

NPI
1801474168
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
EYE CENTERS OF TENNESSEE, LLC
Practice address
3302 Main Street
Pikeville, TN 37367
Phone
(931) 456-2728
Fax
(931) 400-5155
NPI assigned
Mar 30, 2021
Organization subpart
No

Authorized official

Name
Raymond K Mays
Title
Ceo
Phone
(931) 456-2728

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 18

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2241173Eye Centers of Tennessee, LLC
3302 Main Street, Pikeville, TN 37367		Certificate of waiverOct 25, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Centers of Tennessee, LLC
3302 Main Street, Pikeville, TN 37367 · (423) 556-0808		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Jan 1, 2002

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080826000107 TN Part B Supplier - Clinic/Group Practice 1355379256 Receives reassigned benefits from 17 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cookeville, TN; Crossville, TN; Jamestown, TN; Livingston, TN; McMinnville, TN; Pikeville, TN; Sparta, TN
O20220310002175 TN DME Supplier - Physician - Optometrist 1355379256 Practice locations: Pikeville, TN

National Provider Directory

Tax ID family
Eye Centers of Tennessee LL (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 152W00000X Yes
Optician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 156FX1800X
Ophthalmology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207W00000X

Addresses

Primary practice location

3302 Main Street
Pikeville, TN 37367

Mailing address

15 Iris LN
Crossville, TN 38555-7528
Phone (931) 456-2728

Other providers in Pikeville, TN

All providers in Pikeville, TN · Optometrist in Tennessee

Sources for this page

Verify at the official NPI Registry.