Active NPI
Andrew R. Schwichtenberg
- Optometrist
- Johnson City, TN
National Provider Identifier
1104017912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODT1154
- Legal business name
- ANDREW R. SCHWICHTENBERG
- Practice address
- 2829 E Oakland Ave Ste 1
Johnson City, TN 37601-1908 - Phone
- (423) 283-4590
- Fax
- (423) 283-0867
- NPI assigned
- Aug 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Andrew R. Schwichtenberg, O.D.
- Title
- Owner
- Phone
- (423) 283-4590
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODT1154 | TN | Primary |
Addresses
Primary practice location
2829 E Oakland Ave Ste 1
Johnson City, TN 37601-1908
Mailing address
2829 E Oakland Ave Ste 1
Johnson City, TN 37601-1908
Phone (423) 283-4590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3597385 | Medicaid | TN |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Limestone, TN
- NPI 1467590554
-
- Optometrist
- Johnson City, TN
- NPI 1023632478
-
- Optometrist
- Johnson City, TN
- NPI 1487244588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1375056000000",
"number": "1104017912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2829 E OAKLAND AVE STE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011908",
"telephone_number": "423-283-4590",
"fax_number": "423-283-0867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2829 E OAKLAND AVE STE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376011908",
"telephone_number": "423-283-4590",
"fax_number": "423-283-0867"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANDREW R. SCHWICHTENBERG",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-06",
"last_updated": "2013-07-29",
"status": "A",
"authorized_official_last_name": "SCHWICHTENBERG",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "423-283-4590",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "TN",
"license": "ODT1154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3597385",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.