Mana Boushehri, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3135 Issued in TN

Practice address

2431 N Germantown Pkwy
Cordova, TN 38016-4494

Phone

(901) 214-0014

NPI assigned

Jul 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Optometry

Education

Southern College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MVP Eyecare PLLCGroup PAC ID 7810249414, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MVP Eyecare PLLC

  • Optometrist
  • Cordova, TN
  • NPI 1275019044
  Medicare reassignment Care Compare group NPD Authorized official
• Wci School Health Services, PLLC

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1417261215
  NPD
• Mid South Vision Center PLLC

  • Optometrist
  • Bartlett, TN
  • NPI 1831358068
  NPD (past)
• Usv Optical Inc.

  • Eyewear Supplier
  • Toms Rivers, NJ
  • NPI 1275556649
  NPD (past)

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1851731145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 N GERMANTOWN PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380164494",
            "telephone_number": "901-214-0014",
            "fax_number": "901-214-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 N GERMANTOWN PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380164494",
            "telephone_number": "901-214-0014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6025 Stage Rd",
            "address_2": "Suite 44",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381348374",
            "country_code": "US",
            "telephone_number": "901-373-4207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 N Germantown Pkwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381338149",
            "country_code": "US",
            "telephone_number": "901-937-1644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1068 Cresthaven Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38119",
            "country_code": "US",
            "telephone_number": "901-683-0024",
            "fax_number": "901-683-0028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1068 Cresthaven Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38119",
            "country_code": "US",
            "telephone_number": "901-683-0024",
            "fax_number": "901-683-0028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUSHEHRI",
        "first_name": "MANA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "883",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2013022117",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Bryce Botts, DDS
• Natalie Boucher, PHARMD
• Wissal Miloud Boudaoud
• Bound by Happiness
• Bound by Hope Counseling, LLC
• Alexander Freeman Bowers, MD
• Juricus C Boyd, BCBA
• Mallissya Braddox
• Christian Bradfield, DPT
• Amber Garnelle Bragg

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.