Individual provider Active NPI

Andrew R Schwichtenberg, O.D.

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1902901713
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODT1154 Issued in TN
Practice address
2829 E Oakland Ave
Suite 1
Johnson City, TN 37601-1347
Phone
(423) 283-4590
Fax
(423) 283-0867
NPI assigned
Sep 14, 2006
Last updated
Sep 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODT1154 TN Primary

Addresses

Primary practice location

2829 E Oakland Ave
Suite 1
Johnson City, TN 37601-1347

Mailing address

2829 E Oakland Ave
Suite 1
Johnson City, TN 37601-1347
Phone (423) 283-4590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODT1154TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
I Care Vision Associates PLLC Optometrist PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 2

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1902901713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 E OAKLAND AVE",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011347",
            "telephone_number": "423-283-4590",
            "fax_number": "423-283-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 E OAKLAND AVE",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011347",
            "telephone_number": "423-283-4590",
            "fax_number": "423-283-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWICHTENBERG",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT1154",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.