NPIMap

Organization Active NPI

Family Eye Care and Pediatric Vision Center, PLLC

  • Optometrist
  • Kingsport, TN
National Provider Identifier
1871656926
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY EYE CARE AND PEDIATRIC VISION CENTER, PLLC
Practice address
1203 N Eastman Rd
Kingsport, TN 37664-3145
Phone
(423) 247-3321
Fax
(423) 247-3631
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Dr. David Corbett Holliman, ODNPI 1649265299
Title
Co-Owner / PLLC Member
Phone
(423) 247-3321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1203 N Eastman Rd
Kingsport, TN 37664-3145

Mailing address

1203 N Eastman Rd
Kingsport, TN 37664-3145
Phone (423) 247-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070615000426 TN Part B Supplier - Clinic/Group Practice 0547369571 Receives reassigned benefits from 3 practitioners
Practice locations: Kingsport, TN

National Provider Directory

National Provider Directory

Locations

1203 N Eastman Rd
Kingsport, TN 37664
Phone (423) 247-3321

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1871656926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643145",
            "telephone_number": "423-247-3321",
            "fax_number": "423-247-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643145",
            "telephone_number": "423-247-3321",
            "fax_number": "423-247-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE AND PEDIATRIC VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "HOLLIMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CORBETT",
        "authorized_official_title_or_position": "CO-OWNER / PLLC MEMBER",
        "authorized_official_telephone_number": "423-247-3321",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.