SOUTHEAST EYE SPECIALISTS PLLC (NPI# 1003437138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003437138 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST EYE SPECIALISTS PLLC |
| Other Organization Name | SOUTHEAST EYE SPECIALISTS MIDDLE TN |
| Practice Address |
28 White Bridge Road Suite 208 Nashville TN 37205 |
| Mailing Address |
341 Cool Springs Blvd Ste 400 Franklin TN 37067-7224 |
| Practice Telephone | 6153272001 |
| Mailing Telephone | 4235087337 |
| Mailing Fax Number | 4235087338 |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | STACEY MICHELLE CRUDUP (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Telephone | 6152340450 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST EYE SPECIALISTS, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| N | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
Allopathic & Osteopathic Physicians | ||
| N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians | ||
| N | 207WX0110X |
Ophthalmology Specialization: Pediatric Ophthalmology and Strabismus Specialist |
Allopathic & Osteopathic Physicians | ||
| N | 207WX0120X |
Ophthalmology Specialization: Cornea and External Diseases Specialist |
Allopathic & Osteopathic Physicians | ||
| N | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GRP6156 | 05 | |
| TN | MEDICARE PIN | 3721447 | 01 |
| TN | 3721447 | 05 | |
| GA | 524169578A | 05 | |
| MEDICARE PIN | GRP6156 | 01 |
| Other Name | Type Code |
|---|---|
| SouthEast Eye Specialists Middle TN | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 342 22nd Ave N, Nashville, TN 372031844 | 6153272001 | 6152342015 |
| 927 N. James Campbell Blvd., Suite 103, Columbia, TN 384012755 | 9318403501 | 9318403505 |
| 980 Professional Park Dr Ste E, Clarksville, TN 370405251 | 6152342011 | 6152342015 |
| 393 Nichol Mill Ln Ste 30, Franklin, TN 370678324 | 6158145000 | 6158145001 |
| 1602 W Northfield Blvd Ste 504, Murfreesboro, TN 371296056 | 6152173321 | 6152173477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518961176 | Southeast Eye Specialists Pllc | Ophthalmology | 7268 Jarnigan Rd, Suite 200, Chattanooga, TN 37421-3097 | 2005-06-10 |
| Street Address |
28 WHITE BRIDGE ROAD SUITE 208 |
| City | NASHVILLE |
| State | TN |
| Zip Code | 37205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609807163 | Melvin L. Butler | Internal Medicine | 28 White Bridge Road, Suite 208, Nashville, TN 37205-1467 | 2006-07-05 |
| 1750437307 | Lisa C Graham | Physician Assistant | 28 White Bridge Road, Suite 208, Nashville, TN 37205-1417 | 2007-01-26 |
| 1770667289 | Middle Tennessee Imaging LLC | Nurse Practitioner | 28 White Bridge Road, Suite 111, Nashville, TN 37205-1466 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548191 | Anne Nicole Koethe | Nurse Practitioner | Saint Thomas Medical Group, 4230 Harding Pike #503, Nashville, TN 37205 | 2020-11-06 |
| 1396307260 | Tyler G Smith | Dentist | 104 Kenner Ave., Suite #101, Nashville, TN 37205 | 2019-07-01 |
| 1487129508 | The Counseling Center At Belle Meade United Methodist Church, LLC | Counselor | Counseling Center At Belle Meade Umc, 121 Davidson Road, Nashville, TN 37205 | 2018-10-04 |
| 1932592953 | Generations Behavioral Health LLC | Psychiatric Hospital | 4423 Forsythe Place, Nashville, TN 37205 | 2015-03-16 |
| 1114323284 | Caroline Rhett Hartman | Counselor | 85 White Bridge Road, Ste 302, Nashville, TN 37205 | 2014-11-17 |
| 1619316387 | Sarah Jane Grayce | Psychiatry & Neurology | 85 White Bridge Rd Ste 302, Nashville, TN 37205 | 2013-06-17 |
| 1902142920 | Smita K Rao | Genetic Counselor, MS | 4220 Harding Pike Ste 200, Nashville, TN 37205 | 2012-12-19 |
| 1225386154 | Jessica Blain Trumble | Registered Nurse | 204 Carden Ave, Nashville, TN 37205 | 2012-08-27 |
| 1962778167 | Bryan Richard Hay | Internal Medicine | 4320 Harding Pike Ste 503, Nashville, TN 37205 | 2012-04-02 |
| 1184998064 | Christopher Snider | Specialist/Technologist, Other | 738 Templeton Dr, Nashville, TN 37205 | 2012-02-24 |
| Find all providers in zip 37205 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780034439 | Alina Lou | Ophthalmology | 2311 Pierce Avenue, Vanderbilt University Ophthalmology Residency Program, Nashville, TN 37232 | 2016-06-14 |
| 1134462450 | Andrew Gordon Meador | Ophthalmology | 1800 Church St Ste 100, Nashville, TN 37203-2233 | 2013-04-04 |
| 1528324662 | Akshay Sebastian Thomas | Ophthalmology | 345 23rd Ave N Ste 350, Nashville, TN 37203-1596 | 2012-04-03 |
| 1205128352 | Trey Amerson Pegram | Ophthalmology | 3443 Dickerson Pike Ste 240, Nashville, TN 37207-2522 | 2011-05-09 |
| 1477875151 | Robin Lee Rice | Ophthalmology | 133 Jefferson Sq, Nashville, TN 37215-3701 | 2010-02-22 |
| 1639336571 | Michael J. Dieckhaus | Ophthalmology | 4306 Harding Pk, Suite 300, Nashville, TN 37205 | 2008-05-19 |
| 1689856700 | Sahar Kohanim | Ophthalmology | 2010 Church St Ste 608, Nashville, TN 37203-2086 | 2007-11-30 |
| 1497975874 | Susannah Quisling Longmuir | Ophthalmology | 593 Stewarts Ferry Pike, Nashville, TN 37214-3414 | 2007-04-26 |
| 1154445591 | Wang Vision Institute, Pllc | Ophthalmology | 1801 W End Ave Ste 1150, Nashville, TN 37203-2528 | 2007-03-19 |
| 1104961085 | Ming X Wang | Ophthalmology | 1801 West End Avenue #1150, Nashville, TN 37203 | 2007-02-20 |
| Find all providers in NASHVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.