Organization Active NPI

Tennessee Vision Partners PLLC

Doing business as Lifetime EyeCare

  • Optometrist
  • Jackson, TN
National Provider Identifier
1902317381
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TENNESSEE VISION PARTNERS PLLC
Doing business as
Lifetime EyeCare
Practice address
2043 Greystone SQ
Jackson, TN 38305-3576
Phone
(731) 668-3424
NPI assigned
Oct 12, 2017
Last updated
Oct 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
Mrs. Kimberly Thoma
Title
Financial Director
Phone
(573) 334-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

2043 Greystone SQ
Jackson, TN 38305-3576

Mailing address

3230 Blattner Dr
Cape Girardeau, MO 63703-6380

Other names 1

  • Lifetime EyeCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180213001943 TN Part B Supplier - Other 7618237611 Receives reassigned benefits from 5 practitioners
Practice locations: Jackson, TN
O20180830001161 TN DME Supplier - Physician - Optometrist 7618237611 Practice locations: Jackson, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Tennessee Vision Partners PLLC2043 Greystone SQ, Jackson, TN 38305-3576(731) 668-3424 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2018

National Provider Directory

National Provider Directory

Locations

3230 Blattner Dr
Cape Girardeau, MO 63703
Phone (573) 334-2020

2043 Greystone Sq
Jackson, TN 38305
Phone (731) 668-3424

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1902317381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BLATTNER DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053576",
            "telephone_number": "731-668-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE VISION PARTNERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "THOMA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "FINANCIAL DIRECTOR",
        "authorized_official_telephone_number": "573-334-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.