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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

DANA A GRIST, OD
1207 N ROAN ST
JOHNSON CITY, TN37601-3974
 Phone: 423-928-1010
 Fax: 423-928-9090
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for DANA A GRIST · (Male)

NPI Number 1033148135
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/01/2006
Last updated 07/18/2012 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
TN License # ODT675
TN Medicaid 3594233
TN Medicare PIN 35942321
TN Medicare UPIN T61178
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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