Southern Tennessee Eye Specialists Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

12179 Issued in TN

Legal business name

SOUTHERN TENNESSEE EYE SPECIALISTS INC.

Practice address

336 Poplar View Pkwy
Suite 1
Collierville, TN 38017-3436

Phone

(901) 854-6220

Fax

(901) 854-6808

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Harold Peter Kavoussi, M.D.NPI 1871694877

Title

Owner

Phone

(901) 854-6220

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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

• Harold Peter Kavoussi, MD

  • Ophthalmology Physician
  • Collierville, TN
  • NPI 1871694877
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1982802559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 POPLAR VIEW PKWY",
            "address_2": "SUITE 1",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173436",
            "telephone_number": "901-854-6220",
            "fax_number": "901-854-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 POPLAR VIEW PKWY",
            "address_2": "SUITE 1",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173436",
            "telephone_number": "901-854-6220",
            "fax_number": "901-854-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TENNESSEE EYE SPECIALISTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "KAVOUSSI",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-854-6220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "12179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1982802559",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI NUMBER",
            "identifier": "1871694877",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Collierville, TN
• Providers in Collierville, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.