Active NPI
Jeffrey O Carlsen, MD
- Ophthalmology Physician
- Johnson City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD38624
- Practice address
- 110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004 - Phone
- (423) 929-2111
- Fax
- (423) 929-0497
- NPI assigned
- May 3, 2006
- Last updated
- Dec 21, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD38624 | TN | Primary |
Addresses
Primary practice location
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Mailing address
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Utah School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 184 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD38624 | TN | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management C Orporation | Current | Accepting new patients | |
| Johnson City Eye Clinic PC | Ophthalmology | Current | Accepting new patients |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Bluegrass Eye Surgery PSC | Ophthalmology | Past | Accepting new patients |
Locations
225 Midway Medical Park
Bristol, TN 37620
Phone (423) 797-4555
321 Midway Medical Park
Bristol, TN 37620
Phone 42392921110
1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380
1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000
110 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 722-0371
110 Med Tech Pkwy
Ste 1
Johnson City, TN 37604
Phone 42372203603507
110 Med Tech Pkwy
Ste 2
Johnson City, TN 37604
Phone (423) 722-0371
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Johnson City, TN
- NPI 1700827961
-
dba First Assist Urgent Care
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
-
dba MSMG Im Eliz
- Internal Medicine Physician
- Elizabethton, TN
- NPI 1184926719
-
dba Ballad Health Medical Associates
- Family Medicine Physician
- Johnson City, TN
- NPI 1982553756
-
- Ophthalmology Physician
- Lebanon, KY
- NPI 1073799268
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Woodridge Hospital
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
dba Johnson City Medical Center
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
dba Johnson City Medical Center
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261353600000",
"number": "1609834076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MED TECH PKWY",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044004",
"telephone_number": "423-929-2111",
"fax_number": "423-929-0497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MED TECH PKWY",
"address_2": "SUITE 1",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044004",
"telephone_number": "423-929-2111",
"fax_number": "423-929-0497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSEN",
"first_name": "JEFFREY",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2009-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TN",
"license": "MD38624",
"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 21, 2009; 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.