MR. MAURISE GENE VANDERGRIFF SR. (NPI# 1427184019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427184019 |
| Entity Type | Individual |
| Full Name | MR. MAURISE GENE VANDERGRIFF SR. |
| Credential | L.D.O. |
| Practice Address |
2415 Chambliss Ave Nw Cleveland TN 37311-3882 |
| Practice Telephone | 4234794397 |
| Practice Fax Number | 4234762974 |
| Mailing Telephone | 4234794397 |
| Mailing Fax Number | 4234762974 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-03-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
DPO 319 | TN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS & BLUE SHIELD | 2002794 | 01 |
| Street Address |
2415 CHAMBLISS AVE NW |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37311-3882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154304574 | William F Buchner, Jr. | Internal Medicine | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2005-11-21 |
| 1760669147 | Cleveland Optical Dispensary, Inc. | Eyewear Supplier (Equipment, not the service) | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2008-01-28 |
| 1316981087 | Gastrointestinal Associates of Cleveland, PC | Internal Medicine | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2006-06-15 |
| 1629011549 | Paul A. Brundage | Internal Medicine | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2006-06-14 |
| 1467418095 | Kari Williams | Nurse Practitioner | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2006-04-22 |
| 1578546990 | Shelia A. Trew | Nurse Practitioner | 2415 Chambliss Ave Nw, Cleveland, TN 37311-3882 | 2005-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114433570 | Kirstee Williams | Counselor | 1120 North Ocoee Street, Lee University, Cleveland, TN 37311 | 2017-12-21 |
| 1285070458 | Scott Daniel Pugh | Counselor | 183 1st St Ne, Cleveland, TN 37311 | 2013-05-15 |
| 1407299191 | Bess E Howard | Nurse Practitioner | 2449 Spring Creek Blvd, Ne, Cleveland, TN 37311 | 2013-04-11 |
| 1588913925 | Thomas C Reese | Hearing Instrument Specialist | 60 25th Street Ne, Suite 5, Cleveland, TN 37311 | 2012-08-30 |
| 1932484607 | Southeast Tn Human Resource Agency | Non-emergency Medical Transport (VAN) | 165 Edwards Street Se, Cleveland, TN 37311 | 2011-10-13 |
| 1588956106 | Lee M Radford | Orthopaedic Surgery | 2350 N Ocoee Street, Cleveland, TN 37311 | 2011-05-16 |
| 1124251913 | Mcfarland Group Inc. | Durable Medical Equipment & Medical Supplies | 1300 25th St Nw # 104, Cleveland, TN 37311 | 2009-08-27 |
| 1952554834 | Bradley Cleveland Services Inc | Counselor | 2611 Bower Lane, Cleveland, TN 37311 | 2008-10-23 |
| 1851543151 | Bradley Cleveland Services, Inc | Counselor | 2601 Bower Lane Se, Cleveland, TN 37311 | 2008-10-17 |
| 1306098082 | Kidney Center of Cleveland, LLC | Clinic/Center | 2253 Chambliss Avenue, Cleveland, TN 37311 | 2008-10-14 |
| Find all providers in zip 37311 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447650650 | Mum-ford Inc | Technician/Technologist | 6129 Saint Clair Ave, Cleveland, OH 44103-1627 | 2014-08-26 |
| 1588930127 | Joseph D Colini | Technician/Technologist | 4320 Pearl Rd, Cleveland, OH 44109-4209 | 2012-03-28 |
| 1063713980 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3061 Westgate, Cleveland, OH 44126-1308 | 2010-11-09 |
| 1164686267 | North Park Optical | Technician/Technologist | 20670 N Park Blvd, Cleveland, OH 44118-4519 | 2008-07-17 |
| 1689852519 | Cleveland Optical Inc | Technician/Technologist | 802 1st St, Cleveland, MS 38732-2310 | 2008-02-01 |
| 1679690929 | William A. Berris | Technician/Technologist | 2183 S Green Rd, Cleveland, OH 44121-3313 | 2007-03-23 |
| 1215052493 | Jeffery Lee Leonard | Technician/Technologist | 2733 Keith St., Cleveland, TN 37311 | 2007-03-20 |
| 1346384351 | Aaron L Wilson | Technician/Technologist | 913 Keith St Nw, Cleveland, TN 37311-1804 | 2007-02-16 |
| 1932247996 | Jerold Optical Inc. | Technician/Technologist | 800 Huron Rd E, Cleveland, OH 44115-1121 | 2007-02-02 |
| 1194825893 | Sam's Club Optical | Technician/Technologist | 10250 Brookpark Road, Cleveland, OH 44130-1106 | 2006-09-22 |
| Find all providers in CLEVELAND | ||||
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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.