DR. FRED H MOTHERSHED (NPI# 1417950262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417950262 |
| Entity Type | Individual |
| Full Name | DR. FRED H MOTHERSHED |
| Credential | O.D. |
| Practice Address |
3353 N Gloster St Tupelo MS 38804-9735 |
| Practice Telephone | 6628443555 |
| Practice Fax Number | 6628405614 |
| Mailing Telephone | 6628443555 |
| Mailing Fax Number | 6628405614 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2011-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 451 | MS | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0880222 | 05 |
| Street Address |
3353 N GLOSTER ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-9735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984086 | Mac Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2020-08-25 |
| 1275917346 | Chelsea Mcknight | Optometrist | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2015-07-17 |
| 1508184706 | Joseph Hyrum Childs | Ophthalmology | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2010-05-12 |
| 1750581781 | Sonya Mitchell Miles | Ophthalmology | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2007-07-18 |
| 1295934529 | Elizabeth Eckard | Optometrist | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2007-07-17 |
| 1275749228 | Nurse Anesthesia Providers, Inc | Anesthesiology | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2007-05-15 |
| 1831140300 | Mothershed Optometry Associates P.l.l.c. | Optometrist | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2006-05-12 |
| 1912958489 | Wesson Ophthalmology Associates P.l.l.c. | Specialist | 3353 N Gloster St, Tupelo, MS 38804-9735 | 2006-05-12 |
| 1164472031 | Tupelo Surgery Center, L.L.C. | Clinic/Center | 3353 N Gloster St, Suite 300, Tupelo, MS 38804-9735 | 2006-05-11 |
| 1275512410 | Robin Seale | Nurse Anesthetist, Certified Registered | 3353 N Gloster St, Suite 300, Tupelo, MS 38804-9735 | 2006-01-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659765998 | Kathryn Mccullough Od LLC | Optometrist | 1028 Fawn Dr, Tupelo, MS 38804-1924 | 2015-03-25 |
| 1992822985 | Lloyd Perry Britt | Optometrist | 2270 W Main St Ste A, Tupelo, MS 38801-3144 | 2007-03-23 |
| 1205951241 | William M Dickerson Jr. | Optometrist | 322 West Main, Tupelo, MS 38802-0497 | 2007-03-20 |
| 1508980178 | Michael David Ware | Optometrist | 837 Kings Crossing Dr, Suite 10, Tupelo, MS 38804-0947 | 2007-03-19 |
| 1053404012 | Joe Chaddrick Kea | Optometrist | 3437 Tupelo Commons, Suite 101, Tupelo, MS 38804-9791 | 2006-10-02 |
| 1770543092 | Maurice Allan Clark | Optometrist | 499 Gloster Creek Village, Suite F3, Tupelo, MS 38801-4631 | 2006-03-23 |
| 1639656523 | Michael Burks Mccullough | Optometrist | 3929 N Gloster St, Tupelo, MS 38804-0915 | 2018-07-24 |
| 1710427208 | Troupe Family Optometry LLC | Optometrist | 1001 Barnes Crossing Rd Ste 181, Tupelo, MS 38804-0919 | 2017-03-02 |
| 1598218752 | Katie Elizabeth Richardson | Optometrist | 2005 W Main St, Tupelo, MS 38801 | 2016-07-24 |
| 1326404401 | Ms Eye Pllc | Optometrist | 1413 W Main St, Tupelo, MS 38801-3400 | 2016-01-05 |
| Find all providers in TUPELO | ||||
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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.