Unknown Individual – Optometrist, NPI 1740410950

Unknown Individual is a healthcare provider. based in Clarksville, Tennessee. specializing in Optometrist. They hold a License No. 2869 (TN). The NPI Number for Unknown Individual is 1740410950

Main info

Organization
Inactive
17 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740410950
Phone
(931) 245-3937
Address
3929 Lamar Dr
Deactivation Date
18 December 2020

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
9316478417
Graduation Year
2009 (17 years ago)
PAC ID
7012048523
Group Practice PAC ID
5395837926
Professional Enrollment ID
I20100628000533
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 3929 Lamar Dr

    Ste B

    Clarksville, TN 37040

    Phone: (931) 245-3937

    Fax: (931) 647-0354

    Type: Location

  • Townsend Court, Townsend, Buckner Pine Subdivision, Clarksville, Montgomery County, Middle Tennessee, Tennessee, 37043, United States

    CLARKSVILLE, TN 370436487

    Phone: (931) 647-8417

    Fax: (931) 648-4435

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2024-01-18 • Largest payer in this snapshot: CooperVision Inc. ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-18

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CooperVision Inc.$18
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37040)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYTN92012Eye and medical examination for diagnosis and treatment, established patient6564

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395837926View full group profile
NameSpecialtyState
O P T O M E T R YTN
O P T O M E T R YTN
O P T O M E T R YTN
O P T O M E T R YTN
O P T O M E T R YTN
O P T O M E T R YTN

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1740410950 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Clarksville, Tennessee may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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