Organization Active NPI

Music City Eye Care LLC

  • Optometrist
  • Murfreesboro, TN
National Provider Identifier
1962053363
Registry record updated Dec 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MUSIC CITY EYE CARE LLC
Practice address
1720 Old Fort Pkwy Ste C160
Murfreesboro, TN 37129-6305
Phone
(651) 230-3554
NPI assigned
Sep 26, 2019
Organization subpart
Yes
Parent organization
MUSIC CITY EYE CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2021

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

Authorized official

Name
Dr. Travis Matthew Johnson, ODNPI 1003890609
Title
Chief
Phone
(615) 203-5037

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

1720 Old Fort Pkwy Ste C160
Murfreesboro, TN 37129-6305

Mailing address

1720 Old Fort Pkwy Ste C160
Murfreesboro, TN 37129-6305
Phone (651) 230-3554

Other identifiers 1

IdentifierTypeStateIssuer
Q005853MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150223001325 TN Part B Supplier - Clinic/Group Practice 2163748864 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murfreesboro, TN

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Music City Eye Care LLC

Locations

140 Joe B Jackson Pkwy
Murfreesboro, TN 37127
Phone (615) 203-9165

1880 N Main St
Shelbyville, TN 37160
Phone (615) 203-9165

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639785600000",
    "number": "1962053363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 OLD FORT PKWY STE C160",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371296305",
            "telephone_number": "651-230-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 OLD FORT PKWY STE C160",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371296305",
            "telephone_number": "651-230-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSIC CITY EYE CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUSIC CITY EYE CARE LLC",
        "enumeration_date": "2019-09-26",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "615-203-5037",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005853",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; 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.