DRS. Kellum & Pike, PC Optometrists

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT514 Issued in TN

Legal business name

DRS. KELLUM & PIKE, PC OPTOMETRISTS

Practice address

215 W Watauga Ave
Johnson City, TN 37604-5628

Phone

(423) 926-0551

Fax

(423) 926-5251

NPI assigned

Jun 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. William A Pike

Title

Doctor of Optometry

Phone

(423) 926-0551

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1073773958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045628",
            "telephone_number": "423-926-0551",
            "fax_number": "423-926-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. KELLUM & PIKE, PC OPTOMETRISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "PIKE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "423-926-0551",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.