SOUTHEASTERN RETINA ASSOCIATES, P.C.
SOUTHEASTERN RETINA ASSOCIATES, P.C. is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1104097310, based in Hixson, TN. The organization lists 2 taxonomy classifications, with Retina Specialist (Ophthalmology) Physician recorded as primary.
Getting there
The practice address on file is 1961 NORTHPOINT BLVD STE 110, Hixson, TN 37343. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 7517862360
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Retina Specialist covers
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. NUCC Health Care Provider Taxonomy, code 207WX0107X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207WX0107X | Retina Specialist (Ophthalmology) Physician Retina Specialist | — | — | primary |
| 207W00000X | Ophthalmology Physician | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1104097310 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Mar 14, 2008 |
| Last updated | Nov 4, 2025 |
| Status | Active |
| Practice address |
1961 NORTHPOINT BLVD STE 110 Hixson, TN 37343 (423) 756-1002 |
| Mailing address |
9050 EXECUTIVE PARK DR STE 202A Knoxville, TN 37923 |
| Other identifiers |
3715425
(TN) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 0 | 4 | 0 | 9 | 7 | 3 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 0 | 4 | 0 | 9 | 5 | 3 | 2 |
Sum = 50 · next multiple of 10 = 50 · check digit = 0 · actual last digit = 0
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.