Optical Boutique Associates, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

OPTICAL BOUTIQUE ASSOCIATES, LLC

Doing business as

Cleveland Eye Optical Boutique

Practice address

2560 Business Park Dr NE
Cleveland, TN 37311-6503

Phone

(423) 472-5401

NPI assigned

Jun 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Cortney Michelle Waycaster, O.D.

Title

Optometrist/Co-Owner/Manager

Phone

(423) 472-5401

Specialties & licenses 1

Addresses

Other names 1

• Cleveland Eye Optical Boutique Doing business as

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1831410984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 BUSINESS PARK DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116503",
            "telephone_number": "423-472-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 BUSINESS PARK DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116503",
            "telephone_number": "423-472-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL BOUTIQUE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A",
        "authorized_official_last_name": "WAYCASTER",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OPTOMETRIST/CO-OWNER/MANAGER",
        "authorized_official_telephone_number": "423-472-5401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Eye Optical Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Eyewear Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.