MICHAEL A. WOLF (NPI# 1164690277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164690277 |
| Entity Type | Organization |
| Organization Name | MICHAEL A. WOLF |
| Practice Address |
122 Old Gray Station Rd Suite 1 Gray TN 37615-3434 |
| Practice Telephone | 4234772020 |
| Practice Fax Number | 4234772196 |
| Mailing Telephone | 4234772020 |
| Mailing Fax Number | 4234772196 |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | MICHAEL ANTHONY WOLF (OWNER) |
| Authorized Official Telephone | 4234772020 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | OD0000001369 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3591864 | 05 |
| Street Address |
122 OLD GRAY STATION RD SUITE 1 |
| City | GRAY |
| State | TN |
| Zip Code | 37615-3434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376174565 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 6722 Charlotte Pike Ste 107, Nashville, TN 37209-4267 | 2020-01-28 |
| 1124527858 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 2012 Crossing Circle, Suite B, Spring Hill, TN 37174-3207 | 2018-02-08 |
| 1710404801 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1207 Villa Pl Ste B, Nashville, TN 37212-3018 | 2017-08-29 |
| 1730606823 | Jand Inc. | Eyewear Supplier (Equipment, not the service) | 401 Church St Ste 7, Nashville, TN 37219-2213 | 2017-08-29 |
| 1104357524 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 2840 N Germantown Pkwy, Memphis, TN 38133-8149 | 2017-03-27 |
| 1114398534 | Dr Mark Lynn & Associates Pllc | Eyewear Supplier (Equipment, not the service) | 1150 Vann Drive, Jackson, TN 38305-6001 | 2015-10-12 |
| 1205206588 | Dr Mark Lynn & Associates Pllc | Eyewear Supplier (Equipment, not the service) | 5307 Highway 153, 101, Hixson, TN 37343-4912 | 2015-09-30 |
| 1518396761 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 10930 Parkside Dr., Knoxville, TN 37934 | 2013-11-08 |
| 1841537107 | The Eyeglass Place | Eyewear Supplier (Equipment, not the service) | 8079 Kingston Pike Ste P, Knoxville, TN 37919-3909 | 2013-01-07 |
| 1699035972 | Barton Perreira Retail II, LLC | Eyewear Supplier (Equipment, not the service) | 4017 Hillsboro Pike, 309-a, Nashville, TN 37215-2777 | 2012-05-21 |
| Find all providers with the same taxonomy | ||||
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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.