Kelly Conyer Hagood, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD0000002994 Issued in TN

Practice address

2306 Knob Creek Rd Ste 106
Johnson City, TN 37604-2366

Phone

(423) 929-2020

Fax

(423) 929-3140

NPI assigned

Dec 27, 2011

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kelly Conyer Dobson Former name

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

Specialty

Optometry

Education

Southern College of Optometry, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Truelight Eye Care, PLLCGroup PAC ID 7517034051, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Truelight Eye Care, PLLC

  • Optometrist
  • Johnson City, TN
  • NPI 1801051750
  Medicare reassignment Care Compare group NPD
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1780953364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 N ROAN ST",
            "address_2": "DR. CARLSON & ASSOCIATES IN THE MALL AT JOHNSON CITY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013130",
            "telephone_number": "423-610-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 KNOB CREEK RD STE 106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042366",
            "telephone_number": "423-929-2020",
            "fax_number": "423-929-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOOD",
        "first_name": "KELLY",
        "middle_name": "CONYER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000002994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DOBSON",
            "middle_name": "CONYER",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tuanzhu Ha, LAC
• Katy Scarlett Hackett, PT
• Candice Nicole Hackler, BS
• Tariq Z Haddadin, M.D.
• Molly Ann Hagemeier, PHYSICAL THERAPIST
• Stephen Lloyd Haile, APN
• Craig M Haire, M.D.
• James B Haire, PA-C
• Hillary Ann Haley, MD
• Kylee Arden Haley, RD

• Optometrist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.

Verify at the official NPI Registry.