NPIMap

Organization Active NPI

Mullins Vision South, PLLC

Doing business as Mullins Vision Sparta

  • Optometrist
  • Sparta, TN
National Provider Identifier
1972141877
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MULLINS VISION SOUTH, PLLC
Doing business as
Mullins Vision Sparta
Practice address
126 E Bockman Way
Sparta, TN 38583-2036
Phone
(931) 836-2235
NPI assigned
Dec 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Stephen R Mullins, ODNPI 1952508806
Title
Owner/Provider
Phone
(931) 252-0830

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

126 E Bockman Way
Sparta, TN 38583-2036

Mailing address

126 E. Bockman Way
Sparta, TN 38583
Phone (931) 252-0830

Other practice location 1

209 E Commercial Ave
Monterey, TN 38574-1413
Phone (931) 839-3937

Other names 1

  • MULLINS VISION SPARTA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200508002870 TN Part B Supplier - Clinic/Group Practice 9133550049 Receives reassigned benefits from 8 practitioners
Practice locations: Sparta, TN

National Provider Directory

National Provider Directory

Locations

209 E Commercial Ave
Monterey, TN 38574
Phone (931) 839-3937

Practitioners & affiliated clinicians

Practitioners 12

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": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1972141877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E. BOCKMAN WAY",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "38583",
            "telephone_number": "931-252-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E BOCKMAN WAY",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385832036",
            "telephone_number": "931-836-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 E Commercial Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "TN",
            "postal_code": "385741413",
            "country_code": "US",
            "telephone_number": "931-839-3937",
            "fax_number": "931-839-3938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MULLINS VISION SOUTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "931-252-0830",
        "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": [
        {
            "organization_name": "MULLINS VISION SPARTA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sparta, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.