Organization Active NPI

I Care Vision Associates PLLC

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1265083455
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
I CARE VISION ASSOCIATES PLLC
Practice address
2829 E Oakland Ave Ste 1
Johnson City, TN 37601-1908
Phone
(423) 283-4590
NPI assigned
Sep 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Dr. Jordan Daniel Harrison, ODNPI 1851811806
Title
Optometrist, Managing Member
Phone
(423) 223-8676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200123002335 TN Part B Supplier - Clinic/Group Practice 4385079193 Receives reassigned benefits from 4 practitioners
Practice locations: Johnson City, TN; Limestone, TN

National Provider Directory

National Provider Directory

Locations

2829 E Oakland Ave
Ste 1
Johnson City, TN 37601
Phone (423) 282-4590

2829 E Oakland Ave
Johnson City, TN 37601
Phone (423) 283-4590

364 Opie Arnold Rd
Limestone, TN 37681
Phone (423) 257-2340

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1265083455",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I CARE VISION ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OPTOMETRIST, MANAGING MEMBER",
        "authorized_official_telephone_number": "423-223-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.