Old Stage Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT 1457 Issued in TN

Legal business name

OLD STAGE EYE CARE

Practice address

15 Old Stage Rd
Suite a
Greeneville, TN 37745-3117

Phone

(423) 639-8856

Fax

(423) 639-8227

NPI assigned

May 29, 2009

Last updated

May 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Kevin Clement, O.D.NPI 1740282417

Title

Owner

Phone

(423) 639-8856

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Kevin Clement, O.D.

  • Optometrist
  • Greeneville, TN
  • NPI 1740282417
  Authorized official Same address or phone

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1386879716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OLD STAGE RD",
            "address_2": "SUITE A",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377453117",
            "telephone_number": "423-639-8856",
            "fax_number": "423-639-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD STAGE RD",
            "address_2": "SUITE A",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377453117",
            "telephone_number": "423-639-8856",
            "fax_number": "423-639-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD STAGE EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "CLEMENT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-639-8856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT 1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.