Individual provider Active NPI

Ryan Livesay, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1871200238
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3783 Issued in TN
Practice address
5959 Poplar Ave
Memphis, TN 38119-3938
Phone
(901) 821-5475
NPI assigned
Nov 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 3783 TN Primary

Addresses

Primary practice location

5959 Poplar Ave
Memphis, TN 38119-3938

Mailing address

750 N Germantown Pkwy Ste 108
Cordova, TN 38018-2303
Phone (901) 758-9000

Other practice location 1

750 N Germantown Pkwy Ste 108
Cordova, TN 38018-2303
Phone (901) 758-9000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241018002196 TN Practitioner - Optometry 6507398260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

428 Perkins Ext
Memphis, TN 38117-3808
Phone (901) 763-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3783TNMDPharmacist
37832TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Eyecare Optical, PLLC Optometrist CurrentSince Dec 13, 2024 Accepting new patients
Infocus Eyecare, PLLC Optometrist CurrentSince Nov 6, 2022 Accepting new patients
Professional Eyecare Optical CurrentSince Dec 13, 2024 Accepting new patients
Dr Richard C. Buck OD PC Optometrist CurrentSince Jul 11, 2024 Accepting new patients
Visionworks, Inc PastSince Jul 11, 2024 Accepting new patients

Locations

750 N Germantown Pkwy
Ste 108
Cordova, TN 38018
Phone (901) 758-9000

2825 N Germantown Pkwy
Ste 103
Memphis, TN 38133
Phone (901) 381-1522

7706 Winchester Rd
Ste 105
Memphis, TN 38125
Phone (901) 752-1551

4562 Poplar Ave
Ste 115
Memphis, TN 38117
Phone (901) 683-1689

428 Perkins Ext
Memphis, TN 38117
Phone (901) 763-2020

5959 Poplar Ave
Memphis, TN 38119
Phone (901) 261-5080

Organizations & group practices 5

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1871200238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N GERMANTOWN PKWY STE 108",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380182303",
            "telephone_number": "901-758-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193938",
            "telephone_number": "901-821-5475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Germantown Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380182303",
            "country_code": "US",
            "telephone_number": "901-758-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVESAY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.