Callie Root, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3891 Issued in TN

Practice address

110 Med Tech Pkwy Ste 1
Johnson City, TN 37604-4004

Phone

(423) 929-2111

NPI assigned

Jun 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johnson City Eye Clinic PCGroup PAC ID 3375448681, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Johnson City Eye Clinic PC

  • Ophthalmology Physician
  • Johnson City, TN
  • NPI 1700827961
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1184465866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 SOUTHWOOD DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376645254",
            "telephone_number": "423-579-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MED TECH PKWY STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044004",
            "telephone_number": "423-929-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "CALLIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Sterling Rollins, M.D.
• Susan Davidson Rollins, MD
• Tracy Romans, NP
• Anjli Romero
• Denis Kipkemoi Rono, PMHNP-BC
• Lisa Kay Root, CRNA
• Rooted Paths Counseling PLLC
• Pamela Roscoe Roscoe
• Daniel Lee Rose, PHARMD, MBA, BCPS
• Jenna Coleman Rose

• 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 Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.