Bedford Vision and Eye Clinic PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1074 Issued in TN

Legal business name

BEDFORD VISION AND EYE CLINIC PLLC

Practice address

915 Colloredo Blvd
Shelbyville, TN 37160-2780

Phone

(931) 684-2197

Fax

(931) 684-8562

NPI assigned

Nov 1, 2017

Last updated

Nov 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy L Shamblin, ODNPI 1649286576

Title

Owner

Phone

(931) 684-2197

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Kathy Lynn Shamblin, OD

  • Vision Therapy Optometrist
  • Shelbyville, TN
  • NPI 1649286576
  Medicare reassignment Care Compare group NPD Authorized official
• Zeke Parker Grissom, OD

  • Optometrist
  • Shelbyville, TN
  • NPI 1164095758
  Medicare reassignment Care Compare group NPD
• Aundrea Kay Henderson Gregory, O.D.

  • Optometrist
  • Shelbyville, TN
  • NPI 1568746816
  Medicare reassignment Care Compare group NPD
• Angela Lee Ann Dabbs, OD

  • Pediatric Optometrist
  • Morristown, TN
  • NPI 1164437836
  NPD (past)

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1992217756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602780",
            "telephone_number": "931-684-2197",
            "fax_number": "931-684-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602780",
            "telephone_number": "931-684-2197",
            "fax_number": "931-684-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD VISION AND EYE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "SHAMBLIN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-684-2197",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bedford County Health Dept
• Bedford County Health Deptartment
• Bedford County Nursing Home
• Bedford Family Practice Urgent Care Inc.
• Bedford Medical Supply Inc (Bedford Medical Supply)
• Bridget C Bell, RN
• Garrison William Benner
• Clement F Bernard, M.D.
• Bryan Berry, APRN, FNP-BC, ONP-C
• Sarah Berry, PA-C

• Optometrist in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.