Individual provider Active NPI

Karen Elaine Conway, OD

  • Optometrist
  • Germantown, TN
National Provider Identifier
1063408672
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2609 Issued in TN
Practice address
9031 Valley Crest LN
Germantown, TN 38138-7829
Phone
(901) 757-2020
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2609 TN Primary

Addresses

Primary practice location

9031 Valley Crest LN
Germantown, TN 38138-7829

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

472 W Poplar Ave Ste 102
Collierville, TN 38017-2595
Phone (901) 329-8055

Other identifiers 1

IdentifierTypeStateIssuer
002740904001OtherTNUHC

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
I20071029000358 TN Practitioner - Optometry 5294822953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Tennessee LLCGroup PAC ID 1759646995, 45 clinicians

Practice addresses (Care Compare)

472 W Poplar Ave
Suite 102
Collierville, TN 38017-2595
Phone (901) 329-8055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2609TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 21, 2020 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist Current Accepting new patients
Meyer Eye Group PLC Past Accepting new patients

Locations

629 Market St
Ste 115
Chattanooga, TN 37402
Phone (423) 265-4306

472 W Poplar Ave
Ste 102
Collierville, TN 38017
Phone (901) 329-8055

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1063408672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 VALLEY CREST LN",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387829",
            "telephone_number": "901-757-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "472 W Poplar Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380172595",
            "country_code": "US",
            "telephone_number": "901-329-8055",
            "fax_number": "901-234-0133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "KAREN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "002740904001",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.