Individual provider Active NPI

Karin Rodriguez Moore, O.D.

  • Optometrist
  • Knoxville, TN
National Provider Identifier
1043248735
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2179 Issued in TN
Practice address
5113 Clinton Hwy
Knoxville, TN 37912-3841
Phone
(865) 409-2242
Fax
(865) 320-9834
NPI assigned
Jun 29, 2006
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2179 TN Primary

Addresses

Primary practice location

5113 Clinton Hwy
Knoxville, TN 37912-3841

Mailing address

5113 Clinton Hwy
Knoxville, TN 37912-3841
Phone (865) 409-2242

Other identifiers 3

IdentifierTypeStateIssuer
4121846OtherTNBCBS & TNCARE SELECT #
3943794MedicaidTN
P00264124OtherTNRAILROAD MEDICARE PROV #

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050526000440 TN Practitioner - Optometry 6507808896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2410 US Hwy 411 S
Maryville, TN 37801
Phone (865) 681-8267

5113 Clinton Hwy
Knoxville, TN 37912-3841
Phone (865) 409-2242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2179TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Vision Care PLLC Optometrist CurrentSince Dec 29, 2016 Accepting new patients
Eyes on Knoxville PLLC Optometrist CurrentSince Apr 6, 2025 Accepting new patients
Steven G Schoemer PC Optometrist PastSince Sep 30, 2021 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

5113 Clinton Hwy
Knoxville, TN 37912
Phone (864) 409-2242

2410 US Highway 411 S
Maryville, TN 37801
Phone (865) 681-8267

Interoperability endpoints

  • Direct secure messaging: karin.moore@uprisedirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1043248735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 CLINTON HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123841",
            "telephone_number": "865-409-2242",
            "fax_number": "865-320-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 CLINTON HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123841",
            "telephone_number": "865-409-2242",
            "fax_number": "865-320-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KARIN",
        "middle_name": "RODRIGUEZ",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS & TNCARE SELECT #",
            "identifier": "4121846",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3943794",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV #",
            "identifier": "P00264124",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.