Individual provider Active NPI

Tangee Melissa Davis, O.D.

  • Optometrist
  • Clarksville, TN
National Provider Identifier
1992936892
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2881 Issued in TN
Practice address
1111 A Fort Campbell Blvd.
Clarksville, TN 37042
Phone
(931) 645-0346
Fax
(931) 645-0348
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2881 TN Primary
Optometrist 152W00000X S-C15-TA-826 AL

Addresses

Primary practice location

1111 A Fort Campbell Blvd.
Clarksville, TN 37042

Mailing address

1302 Sun Valley Rd
Clarksville, TN 37040-4371
Phone (205) 253-1277

Other identifiers 1

IdentifierTypeStateIssuer
1534403MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20141007000743 TN Practitioner - Optometry 7618007691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hermitage Eye Care, PLLCGroup PAC ID 0446576359, 48 clinicians

Practice addresses (Care Compare)

1111 A Fort Campbell Blvd
Clarksville, TN 37042-6426
Phone (931) 645-0346

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hermitage Eye Care PLLC Optometrist CurrentSince Mar 3, 2023 Accepting new patients
John J Maria OD PC Optometrist PastSince Jul 5, 2017 Accepting new patients
Hermitage Eye Care PLLC Optometrist PastSince Feb 23, 2025 Accepting new patients

Locations

782 Old Hickory Blvd
Ste 204
Brentwood, TN 37027
Phone (615) 373-9992

1111 Fort Campbell Blvd
#A
Clarksville, TN 37042
Phone (931) 645-0346

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1992936892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 SUN VALLEY RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370404371",
            "telephone_number": "205-253-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 A FORT CAMPBELL BLVD.",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37042",
            "telephone_number": "931-645-0346",
            "fax_number": "931-645-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TANGEE",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2881",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-C15-TA-826",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1534403",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.