Southern College of Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SOUTHERN COLLEGE OF OPTOMETRY

Practice address

1225 Madison Ave
Memphis, TN 38104-2211

Phone

(901) 722-3250

Fax

(901) 722-3347

NPI assigned

Aug 24, 2005

Last updated

Jul 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James E Venable, ODNPI 1891788956

Title

Vice President of Clinical Op

Phone

(901) 722-3324

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Southern College of Optometry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southern College of Optometry

  dba University Eye Care

  • Optometrist
  • Memphis, TN
  • NPI 1518309202
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Southern College of Optometry

  dba University Eye Care

  • Optometrist
  • Memphis, TN
  • NPI 1518309202
  NPPES parent name

Practitioners 115

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.

• Mary Bartuccio Valentino, O.D.

  • Pediatric Optometrist
  • Memphis, TN
  • NPI 1326124991
  Medicare reassignment Care Compare group NPD
• Marie I. Bodack, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1356310353
  Medicare reassignment Care Compare group NPD
• John B Campbell, OD

  • Optometrist
  • Memphis, TN
  • NPI 1144213331
  Medicare reassignment Care Compare group NPD
• Theresa Karyn Cassidy, OD

  • Optometrist
  • Memphis, TN
  • NPI 1124511266
  Medicare reassignment Care Compare group NPD
• Patricia Cisarik, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1508869009
  Medicare reassignment Care Compare group NPD
• Janette D Dumas, OD

  • Optometrist
  • Memphis, TN
  • NPI 1720071913
  Medicare reassignment Care Compare group NPD
• Jason D Duncan, OD

  • Optometrist
  • Memphis, TN
  • NPI 1881687077
  Medicare reassignment Care Compare group NPD
• Lindsay M Elkins, OD

  • Optometrist
  • Memphis, TN
  • NPI 1114181096
  Medicare reassignment Care Compare group NPD
• Michael Scott Ensor, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1679501019
  Medicare reassignment Care Compare group NPD
• Jacqueline Rose Fiddler, OD

  • Optometrist
  • Arlington, TN
  • NPI 1013532480
  Medicare reassignment Care Compare group NPD
• Patrick Fiddler, OD

  • Optometrist
  • Memphis, TN
  • NPI 1699388918
  Medicare reassignment Care Compare group NPD
• Daniel Gunn Fuller, O.D.

  • Optometrist
  • Memphis, TN
  • NPI 1023087632
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1851384986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250",
            "fax_number": "901-722-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250",
            "fax_number": "901-722-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COLLEGE OF OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "VENABLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT OF CLINICAL OP",
        "authorized_official_telephone_number": "901-722-3324",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southern Home Care
• Southern Liberty Transportation Company (Southern Transit)
• Southern Medical Clinic

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.