Individual provider Active NPI

Mohammad Mona, OD

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1659261899
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3961 Issued in TN
Practice address
2328 Knob Creek Rd Ste 506
Johnson City, TN 37604-2585
Phone
(423) 722-1311
NPI assigned
Jul 8, 2025
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3961 TN Primary

Addresses

Primary practice location

2328 Knob Creek Rd Ste 506
Johnson City, TN 37604-2585

Mailing address

2328 Knob Creek Rd Ste 506
Johnson City, TN 37604-2585
Phone (423) 722-1311

Other practice location 1

2328 Knob Creek Rd Ste 500
Johnson City, TN 37604-2585
Phone (423) 722-1311

Other practice location 2

444 Clinchfield St Ste 104
Kingsport, TN 37660-3859
Phone (423) 722-1311

Other names 1

  • Mohammad Omar Mona Other name

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
I20250723004527 TN Practitioner - Optometry 5597271619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Reeves Eye InstituteGroup PAC ID 7113185406, 3 clinicians

Practice addresses (Care Compare)

2328 Knob Creek Rd
Suite 506
Johnson City, TN 37604-2585
Phone (423) 722-1311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3961TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Reeves Eye Institute CurrentSince Jul 8, 2025 Accepting new patients

Locations

2328 Knob Creek Rd
Ste 500
Johnson City, TN 37604
Phone (423) 722-1310

2328 Knob Creek Rd
Ste 506
Johnson City, TN 37604
Phone (423) 722-1131

444 Clinchfield St
Ste 104
Kingsport, TN 37660
Phone (423) 722-1311

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1659261899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 KNOB CREEK RD STE 506",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042585",
            "telephone_number": "423-722-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 KNOB CREEK RD STE 506",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042585",
            "telephone_number": "423-722-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2328 Knob Creek Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042585",
            "country_code": "US",
            "telephone_number": "423-722-1311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Clinchfield St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603859",
            "country_code": "US",
            "telephone_number": "423-722-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONA",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMAD",
            "last_name": "MONA",
            "middle_name": "OMAR",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.