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SOUTHEASTERN RETINA ASSOCIATES, P.C.
NPI 1104097310
Ophthalmology - Retina Specialist in Hixson, TN

Active since March 14, 2008CLIA Certified · 3 labs
1961 NORTHPOINT BLVD STE 110, HIXSON, TN 37343(423) 756-1002 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2025, Jan 16, 2023, Jan 18, 2021 and 2 more (5 updates tracked since 2020).

About Southeastern Retina Associates, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN RETINA ASSOCIATES, P.C. (NPI 1104097310) is a healthcare organization registered as a retina specialist in Hixson, Tennessee and active in the NPI registry since March 2008. The organization holds 3 active CLIA laboratory certificates and lists Andrew Laverghetta, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104097310
Entity TypeOrganization
Primary Taxonomy207WX0107X
Legal Business NameSOUTHEASTERN RETINA ASSOCIATES, P.C.
Location Address1961 NORTHPOINT BLVD STE 110Hixson, TN 37343-4556
Mailing Address9050 Executive Park Dr Ste 202aKnoxville, TN 37923-4670 · (865) 588-0811 · Fax (865) 934-3892
Phone(423) 756-1002
Organization SubpartNo
Authorized OfficialAndrew LaverghettaCeo · (865) 474-7596
Enumeration DateMarch 14, 2008
Last NPPES UpdateNovember 4, 20255 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
✔ NPI 1104097310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X
1961 NORTHPOINT BLVD STE 110, Hixson, TN 37343
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Other Identifiers 1

Medicaid3715425TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2095252

Southeastern Retina Associates · Hixson, TN
Active · expires May 3, 2027
CLIA Number44D2095252
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorRichard Breazeale
Laboratory Phone(423) 756-1002
Laboratory LocationSoutheastern Retina Associates1961 Northpoint Blvd, Ste 110, Hixson, TN 37343
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 44D2113721

Southeastern Retina Associates, PC · Knoxville, TN
Active · expires May 30, 2028
CLIA Number44D2113721
Laboratory TypePhysician Office
Certificate Effective DateMay 31, 2026
Certificate Expiration DateMay 30, 2028
Laboratory DirectorStephen L. Perkins
Laboratory Phone(865) 588-0811
Laboratory LocationSoutheastern Retina Associates, PC140 Capital Drive, Knoxville, TN 37922
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 44D2095771

Southeastern Retina Associates, PC · Knoxville, TN
Active · expires May 11, 2027
CLIA Number44D2095771
Laboratory TypePhysician Office
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorJoseph Googe
Laboratory Phone(865) 588-0811
Laboratory LocationSoutheastern Retina Associates, PC1124 E Weisgarber Rd, Suite 207, Knoxville, TN 37909
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUI WANG MD
Ophthalmology
1961 NORTHPOINT BLVD STE 110
HIXSON, TN 37343
Hamilton County (423) 756-1002
DEVON GHODASRA M.D.
Ophthalmology (Retina Specialist)
1961 NORTHPOINT BLVD STE 110
HIXSON, TN 37343
Hamilton County (423) 756-1002
ASGHAR HAIDER MD
Ophthalmology (Retina Specialist)
1961 NORTHPOINT BLVD STE 110
HIXSON, TN 37343
Hamilton County (423) 756-1002
DR. FRANCIS C DECROOS M.D.
Ophthalmology (Retina Specialist)
1961 NORTHPOINT BLVD STE 110
HIXSON, TN 37343
Hamilton County (423) 756-1002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeastern Retina Associates, P.C.'s NPI number?

The NPI number for Southeastern Retina Associates, P.C. is 1104097310. It was assigned to this organization in the NPPES registry on March 14, 2008.

Where is Southeastern Retina Associates, P.C. located?

Southeastern Retina Associates, P.C. is located at 1961 Northpoint Blvd Ste 110, Hixson, TN 37343. The listed phone number is (423) 756-1002.

What is Southeastern Retina Associates, P.C.'s specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Does Southeastern Retina Associates, P.C. hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Southeastern Retina Associates, P.C. accept?

Health plans from Alliant Health Plans, Inc., Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and Ambetter of Alabama and 2 other insurers list Southeastern Retina Associates, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeastern Retina Associates, P.C. was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.