Dana Alan Grist, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT675 Issued in TN

Practice address

1207 N Roan St
Johnson City, TN 37601-3974

Phone

(423) 928-1010

Fax

(423) 928-9090

NPI assigned

Jul 1, 2006

Last updated

Jul 18, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dana a. Grist, O.D.

  dba Family Eyecare Center

  • Optometrist
  • Johnson City, TN
  • NPI 1144498098
  Authorized official Same address or phone
• Family Eyecare Center of Johnson City, PLLC

  • Corneal and Contact Management Optometrist
  • Johnson City, TN
  • NPI 1902144256
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1033148135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013974",
            "telephone_number": "423-928-1010",
            "fax_number": "423-928-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013974",
            "telephone_number": "423-928-1010",
            "fax_number": "423-928-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIST",
        "first_name": "DANA",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3594233",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Griffin, COTA/L
• Sumalee Griffith
• Steven D Grijalva, MD
• Abigale Grimm, MCD, CCC-SLP
• Melissa L Grissinger, FNP
• Eric J Groen, DO
• Violetta Vadimovna Gromova
• Ashley Gross, FNP
• Michael J Grosserode, MD
• Owen David Grove, M.D.

• Optometrist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.