Keith Family Vision Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

T1320 Issued in TN

Legal business name

KEITH FAMILY VISION CLINIC

Practice address

119 Boone Ridge Dr
Suite 101
Johnson City, TN 37615-4998

Phone

(423) 283-7300

Fax

(423) 283-4729

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Allen Keith, O.D.NPI 1063528446

Title

President

Phone

(423) 283-7300

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

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

• Michael Allen Keith, O.D.

  • Optometrist
  • Johnson City, TN
  • NPI 1063528446
  Medicare reassignment Care Compare group NPD Authorized official
• Allison Lauren Clower, OD

  • Optometrist
  • Mountain Home, TN
  • NPI 1427888734
  Medicare reassignment Care Compare group NPD
• Gregory Lee Keith, O.D.

  • Optometrist
  • Johnson City, TN
  • NPI 1952488314
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1801927546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "SUITE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-283-7300",
            "fax_number": "423-283-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "SUITE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-283-7300",
            "fax_number": "423-283-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH FAMILY VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-283-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "T1320",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "T1679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Reinhart Kaudewitz, OD
• William Meade Kauffman, M.D.
• Katherine Kazen, MD
• Shae Keane
• Kara Loven Keene, PA-C
• Gregory Lee Keith, O.D.
• Michael Allen Keith, O.D.
• Raquel Keithley, P.T. D.P.T P.C.S
• Krysten Kelch, LCSW
• Laura Ann Kellicut, MA

• 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 Sep 3, 2010; 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.