EYE CARE SURGERY CENTER OF OLIVE BRANCH,LLC
NPI 1720161771
Clinic/Center - Ambulatory Surgical in Olive Branch, MS

Active since October 23, 2006CLIA 25D1024744 · Waiver
6947 CRUMPLER BLVD, SUITE 105, OLIVE BRANCH, MS 38654(662) 893-3305(662) 893-3306 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2022, Mar 15, 2018 (2 updates tracked since 2018).

About Eye Care Surgery Center Of Olive Branch,llc NPPES

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

EYE CARE SURGERY CENTER OF OLIVE BRANCH,LLC (NPI 1720161771) is a healthcare organization registered as an ambulatory surgical in Olive Branch, Mississippi and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through April 20, 2028 and lists Subba R. Gollamudi, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1720161771
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEYE CARE SURGERY CENTER OF OLIVE BRANCH,LLC
Location Address6947 CRUMPLER BLVD, SUITE 105Olive Branch, MS 38654-1922
Mailing Address825 Ridge Lake BlvdMemphis, TN 38120-9411 · (901) 685-2200 · Fax (901) 255-5631
Fax(662) 893-3306
Organization SubpartNo
Authorized OfficialSubba R. GollamudiMedical Director · (901) 685-2200
Enumeration DateOctober 23, 2006
Last NPPES UpdateJuly 25, 20222 updates tracked since enumeration
NPPES CertifiedJuly 25, 2022
NPI 1720161771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
6947 CRUMPLER BLVD, Olive Branch, MS 38654

Other Identifiers 1

Medicaid03058373MS

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

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 25D1024744

Eye Care Surgery Center Of Olive Branch · Olive Branch, MS
Active · expires Apr 20, 2028
CLIA Number25D1024744
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 21, 2026
Certificate Expiration DateApril 20, 2028
Laboratory DirectorMary C. Schanzer
Laboratory Phone(662) 893-3306
Laboratory LocationEye Care Surgery Center Of Olive Branch6947 Crumpler Blvd Suite 105, Olive Branch, MS 38654
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
86 services66 patients

Other Providers at the Same Location NPPES 8

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

Optometrist
6947 CRUMPLER BLVD, SUITE 100
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD, SUITE 100
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD, SUITE 100
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD
OLIVE BRANCH, MS 38654
Optometrist
6947 CRUMPLER BLVD
OLIVE BRANCH, MS 38654

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 Eye Care Surgery Center Of Olive Branch,llc's NPI number?

The NPI number for Eye Care Surgery Center Of Olive Branch,llc is 1720161771. It was assigned to this organization in the NPPES registry on October 23, 2006.

Where is Eye Care Surgery Center Of Olive Branch,llc located?

Eye Care Surgery Center Of Olive Branch,llc is located at 6947 Crumpler Blvd Suite 105, Olive Branch, MS 38654. The listed phone number is (662) 893-3305.

What is Eye Care Surgery Center Of Olive Branch,llc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Eye Care Surgery Center Of Olive Branch,llc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D1024744) is associated with this NPI, valid through April 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eye Care Surgery Center Of Olive Branch,llc accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter of Alabama and 3 other insurers list Eye Care Surgery Center Of Olive Branch,llc 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 Eye Care Surgery Center Of Olive Branch,llc was last updated on July 25, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.