Individual provider Active NPI

Tara Jean Parnell, OD

  • Optometrist
  • Southport, NC
National Provider Identifier
1851422158
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1721 Issued in NC
Practice address
1456 N Howe St
Suite 100
Southport, NC 28461-2754
Phone
(910) 454-9458
Fax
(910) 454-0776
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1721 NC Primary

Addresses

Primary practice location

1456 N Howe St
Suite 100
Southport, NC 28461-2754

Mailing address

1456 N Howe St
Suite 100
Southport, NC 28461-2754
Phone (910) 454-9458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727000112 NC Practitioner - Optometry 2567432834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1456 N Howe St
Suite 100
Southport, NC 28461-2674
Phone (910) 454-9226

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1721NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tara J Parnell, OD PA Optometrist CurrentSince Jan 1, 2000 Accepting new patients

Locations

1456 N Howe St
Ste 100
Southport, NC 28461
Phone (910) 454-8889

1125 N Howe St
Southport, NC 28461
Phone (910) 454-9226

1675 N Howe St
Southport, NC 28461
Phone (910) 454-4218

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1851422158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 N HOWE ST",
            "address_2": "SUITE 100",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612754",
            "telephone_number": "910-454-9458",
            "fax_number": "910-454-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 N HOWE ST",
            "address_2": "SUITE 100",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612754",
            "telephone_number": "910-454-9458",
            "fax_number": "910-454-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNELL",
        "first_name": "TARA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.