Mid South Vision Center PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TN611 Issued in TN

Legal business name

MID SOUTH VISION CENTER PLLC

Practice address

6025 Stage Rd Ste 44
Bartlett, TN 38134-8374

Phone

(901) 373-4207

Fax

(901) 373-4208

NPI assigned

Jun 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Stephen R Davis, O.D.NPI 1558442129

Title

Optometrist

Phone

(901) 373-4207

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Stephen R Davis OD Other name

Locations

Practitioners 6

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

• Stephen R. Davis, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1558442129
  NPD (past) Authorized official
• Mana Boushehri, O.D.

  • Optometrist
  • Cordova, TN
  • NPI 1851731145
  NPD (past)
• Marion Flowers, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1518397629
  NPD (past)
• Helen Ong Lim, OD

  • Optometrist
  • Memphis, TN
  • NPI 1801880406
  NPD (past)
• Danielle Leblanc Thompson, OD

  • Optometrist
  • Memphis, TN
  • NPI 1053832246
  NPD (past)
• Jeffrey Scott Walter, O.D.

  • Optometrist
  • Newport, PA
  • NPI 1972758837
  NPD (past)

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1831358068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 STAGE RD STE 44",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381348374",
            "telephone_number": "901-373-4207",
            "fax_number": "901-373-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 STAGE RD STE 44",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381348374",
            "telephone_number": "901-373-4207",
            "fax_number": "901-373-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH VISION CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "901-373-4207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1765406",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN CARE SELECT",
            "identifier": "0197238",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004616972",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0197238",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephen R Davis OD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Stephen R Davis OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Latrice Miller, FNP

• Optometrist in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.