Individual provider Active NPI

David Keith Talley, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1982697058
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1797 Issued in TN
Practice address
2070 Whitney Ave
Memphis, TN 38127-9014
Phone
(901) 357-0371
Fax
(901) 358-7574
NPI assigned
Aug 24, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1797 TN Primary

Addresses

Primary practice location

2070 Whitney Ave
Memphis, TN 38127-9014

Mailing address

2070 Whitney Ave
Memphis, TN 38127-9014
Phone (901) 357-0371

Other identifiers 2

IdentifierTypeStateIssuer
1797OtherTNOD
3941896MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240103004216 FL Practitioner - Optometry 3173559796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 N Howard Ave
Suite 100
Tampa, FL 33606-1213
Phone (727) 581-8706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1797TNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Physicians of Pinellas, PA Optometrist CurrentSince Dec 4, 2023 Accepting new patients
The Eye Physicians of Pinellas, PA CurrentSince Dec 4, 2023 Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients

Locations

3220 N McMullen Booth Rd
Clearwater, FL 33761
Phone (727) 723-8706

148 13th St SW
Largo, FL 33770
Phone (727) 450-3030

148 13th St SW
Ste 200
Largo, FL 33770
Phone (727) 450-3030

11925 Sheldon Rd
Tampa, FL 33626
Phone (813) 792-0444

501 N Howard Ave
Ste 100
Tampa, FL 33606
Phone (813) 253-2727

Interoperability endpoints

  • Direct secure messaging: david.talley@direct.revolutionehr.com
  • Direct secure messaging: dtalley@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982697058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381279014",
            "telephone_number": "901-357-0371",
            "fax_number": "901-358-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381279014",
            "telephone_number": "901-357-0371",
            "fax_number": "901-358-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "DAVID",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD",
            "identifier": "1797",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941896",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.