Pulaski Eye Care, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PULASKI EYE CARE, INC.

Practice address

1125 E College St
Pulaski, TN 38478-4520

Phone

(931) 363-4557

NPI assigned

Aug 11, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jason Anthony Fort, ODNPI 1013575273

Title

President

Phone

(629) 235-4230

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Fort, OD

  • Optometrist
  • Lawrenceburg, TN
  • NPI 1013575273
  Medicare reassignment NPD Authorized official
• Caswell Hughes Wadley, O. D.

  • Optometrist
  • Pulaski, TN
  • NPI 1427088178
  Medicare reassignment NPD

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1851066872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784520",
            "telephone_number": "931-363-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784520",
            "telephone_number": "931-363-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "FORT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "629-235-4230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q052848",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427088178",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Michael Poole, BS
• Premier Internal Medicine of Giles County
• Premier Internal Medicine of Giles County, PLLC
• Pulaski Anesthesia Services LLC
• Pulaski Dental PLLC
• Pulaski Pediatrics, PLLC
• Steven Zachary Putnam
• R.J. Legreid II, MD
• Cameron Marie Rai, CPM
• Christopher Michael Reece, DDS

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

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