Individual provider Active NPI

Torrey Jon Carlson, O.D.

  • Optometrist
  • Kingsport, TN
National Provider Identifier
1053360131
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN1695 Issued in TN
Practice address
2101 Fort Henry Dr SPC E-9
Kingsport, TN 37664-3658
Phone
(865) 217-1010
Fax
(865) 444-4827
NPI assigned
May 8, 2006
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 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 TN1695 TN Primary

Addresses

Primary practice location

2101 Fort Henry Dr SPC E-9
Kingsport, TN 37664-3658

Mailing address

505 Magnolia Ridge Dr
Jonesborough, TN 37659-7442
Phone (423) 292-6312

Other identifiers 1

IdentifierTypeStateIssuer
4073509OtherTNBCBS

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
I20040927000639 TN Practitioner - Optometry 6103895263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Torrey J. Carlson and AssociatesGroup PAC ID 2365401510, 21 clinicians

Practice addresses (Care Compare)

2600 E Stone Dr
Suite 10
Kingsport, TN 37660-5919
Phone (865) 217-1010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1695TNMDProfessional Counselor
TN1695TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Eye Care PC Optometrist Past Accepting new patients
Luxottica of America Inc PastSince Mar 11, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: torrey.carlson@direct.revolutionehr.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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1053360131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 MAGNOLIA RIDGE DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376597442",
            "telephone_number": "423-292-6312",
            "fax_number": "423-913-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FORT HENRY DR SPC E-9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643658",
            "telephone_number": "865-217-1010",
            "fax_number": "865-444-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TORREY",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN1695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4073509",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.