Active NPI
Mary K Conway, O. D.
- Pediatric Optometrist
- Knoxville, TN
National Provider Identifier
1790823201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Optometrist
- License
- TN 1239
- Practice address
- 7600 H Kingston Pike
Knoxville, TN 37919-5604 - Phone
- (865) 691-1118
- Fax
- (865) 691-2253
- NPI assigned
- Feb 5, 2007
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | TN 1239 | TN | |
| Pediatric Optometrist | 152WP0200X | TN 1239 | TN | Primary |
Addresses
Primary practice location
7600 H Kingston Pike
Knoxville, TN 37919-5604
Mailing address
3609 Aztec LN
Knoxville, TN 37931-3687
Phone (865) 690-4019
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0175608 | Other | TN | BCBS OF TENNESSEE |
| 54-19543 | Other | TN | AETNA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TN 1239 | TN | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Campbell Cunningham Taylor PC | Current | Accepting new patients | |
| Dr. Mary Conway & Associates LLC | Current | Accepting new patients | |
| Campbell Cunningham Taylor PC | Current | Accepting new patients |
Locations
1124 E Weisgarber Rd
Ste 100
Knoxville, TN 37909
Phone 8655840905322
4613 Papermill Dr
Knoxville, TN 37909
Phone (865) 584-8551
Interoperability endpoints
- mconway@ccth.intellechartdirect.net
Organizations & group practices 3
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.
-
- Optometrist
- Knoxville, TN
- NPI 1407850944
-
- Optometrist
- Maryville, TN
- NPI 1548838469
-
dba Campbell, Cunningham, & Taylor Optical Dispensary
- Durable Medical Equipment & Medical Supplies
- Knoxville, TN
- NPI 1902008162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1790823201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3609 AZTEC LN",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379313687",
"telephone_number": "865-690-4019",
"fax_number": "865-691-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 H KINGSTON PIKE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195604",
"telephone_number": "865-691-1118",
"fax_number": "865-691-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "MARY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "O. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TN",
"license": "TN 1239",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "TN",
"license": "TN 1239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TENNESSEE",
"identifier": "0175608",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "54-19543",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.