Individual provider Active NPI

George S Malone, OD

  • Optometrist
  • Tazewell, TN
National Provider Identifier
1639159098
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T792 Issued in TN
Practice address
114 Irish Cemetery Rd
Tazewell, TN 37879-3610
Phone
(423) 626-7249
Fax
(423) 626-6630
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T792 TN Primary

Addresses

Primary practice location

114 Irish Cemetery Rd
Tazewell, TN 37879-3610

Mailing address

PO Box 430
Tazewell, TN 37879-0430
Phone (423) 626-7249

Other identifiers 1

IdentifierTypeStateIssuer
3594654MedicaidTN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101214000220 TN Practitioner - Optometry 3779690300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
George Steven Malone, O.D.P.C.Group PAC ID 4284754987, 2 clinicians

Practice addresses (Care Compare)

114 Irish Cemetery Rd
Tazewell, TN 37879-3610
Phone (423) 626-7249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
George Steven Malone, O.D.P.C. Optometrist CurrentSince Oct 1, 1980 Accepting new patients
Halls Vision Clinic, Inc. Optometrist PastSince Dec 1, 2000 Accepting new patients

Locations

114 Irish Cemetery Rd
Tazewell, TN 37879
Phone (423) 626-7249

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1639159098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378790430",
            "telephone_number": "423-626-7249",
            "fax_number": "423-626-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 IRISH CEMETERY RD",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378793610",
            "telephone_number": "423-626-7249",
            "fax_number": "423-626-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "GEORGE",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "T792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3594654",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tazewell, TN

Sources for this page

Verify at the official NPI Registry.