Active NPI
John Michael Condry, O.D.
- Optometrist
- Knoxville, TN
National Provider Identifier
1184675811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TOD451
- Practice address
- 6719 Maynardville Hwy
Knoxville, TN 37918-5348 - Phone
- (865) 922-3937
- Fax
- (865) 922-8412
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TOD451 | TN | Primary |
Addresses
Primary practice location
6719 Maynardville Hwy
Knoxville, TN 37918-5348
Mailing address
6719 Maynardville Hwy
Knoxville, TN 37918-5348
Phone (865) 922-3937
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2240322 | Other | TN | UNITED HEALTHCARE |
| 3032278 | Other | TN | BCBST |
| 4833 | Other | TN | DAVIS VISION |
| 3032278 | Medicaid | TN | |
| 12763 | Other | TN | SPECTERA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TOD451 | TN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven Elliott OD and Associates Inc | Optometrist | Past | Accepting new patients |
| Optical Market, Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1184675811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6719 MAYNARDVILLE HWY",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379185348",
"telephone_number": "865-922-3937",
"fax_number": "865-922-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6719 MAYNARDVILLE HWY",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379185348",
"telephone_number": "865-922-3937",
"fax_number": "865-922-8412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDRY",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "TOD451",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2240322",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "3032278",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "4833",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3032278",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA",
"identifier": "12763",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.