Organization Active NPI

Truelight Eye Care, PLLC

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1801051750
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1296 Issued in TN
Legal business name
TRUELIGHT EYE CARE, PLLC
Practice address
2306 Knob Creek Rd
#106
Johnson City, TN 37604-2366
Phone
(423) 929-2020
Fax
(423) 929-3140
NPI assigned
Jul 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Dr. Kathryn Allyson Bohlman, O.D.
Title
Optometrist
Phone
(423) 929-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1663 TN
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1296 TN Primary

Addresses

Primary practice location

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

Mailing address

2306 Knob Creek Rd
#106
Johnson City, TN 37604-2366
Phone (423) 929-2020

Other identifiers 2

IdentifierTypeStateIssuer
1801051750OtherTNGROUP PROVIDER -SUPPLIER NPI
1506422MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080924000556 TN Part B Supplier - Clinic/Group Practice 7517034051 Receives reassigned benefits from 2 practitioners
Practice locations: Johnson City, TN

National Provider Directory

National Provider Directory

Locations

1304 Patton Ave
Asheville, NC 28806

2306 Knob Creek Rd
Ste 106
Johnson City, TN 37604
Phone (423) 929-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1801051750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 KNOB CREEK RD",
            "address_2": "#106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042366",
            "telephone_number": "423-929-2020",
            "fax_number": "423-929-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 KNOB CREEK RD",
            "address_2": "#106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042366",
            "telephone_number": "423-929-2020",
            "fax_number": "423-929-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUELIGHT EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "BOHLMAN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ALLYSON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "423-929-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1663",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PROVIDER -SUPPLIER NPI",
            "identifier": "1801051750",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506422",
            "state": "TN"
        }
    ],
    "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 Aug 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.