Individual provider Active NPI

Miranda Wentworth Cox, OD

  • Optometrist
  • Knoxville, TN
National Provider Identifier
1891569158
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3851 Issued in TN
Practice address
4620 Kingston Pike
Knoxville, TN 37919-5230
Phone
(865) 584-7739
Fax
(865) 584-3624
NPI assigned
Nov 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3851 TN Primary

Addresses

Primary practice location

4620 Kingston Pike
Knoxville, TN 37919-5230

Mailing address

4620 Kingston Pike
Knoxville, TN 37919-5230
Phone (865) 584-7739

Other practice location 1

9700 Kingston Pike Ste 15
Knoxville, TN 37922-3385
Phone (865) 539-2835

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
I20231205002427 TN Practitioner - Optometry 3173972973 Practice locations: Knoxville, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4620 Kingston Pike
Knoxville, TN 37919-5230
Phone (865) 584-7739

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3851TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clancy Optical Company PastSince Jun 9, 2024 Accepting new patients
National Vision Inc Optometrist PastSince Nov 1, 2023 Accepting new patients
Clancy Optical Company PastSince Jun 9, 2024 Accepting new patients

Organizations & group practices 3

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1891569158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195230",
            "telephone_number": "865-584-7739",
            "fax_number": "865-584-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195230",
            "telephone_number": "865-584-7739",
            "fax_number": "865-584-3624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 Kingston Pike Ste 15",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379223385",
            "country_code": "US",
            "telephone_number": "865-539-2835",
            "fax_number": "865-539-3737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COX",
        "first_name": "MIRANDA",
        "middle_name": "WENTWORTH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.