Active NPI
Jeffrey Allen Ollis II, MD
- Anesthesiology Physician
- Charleston, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 48263
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-8908 - Phone
- (843) 792-1414
- NPI assigned
- Aug 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TN | ||
| Anesthesiology Physician | 207L00000X | 48263 | TN | Primary |
| Anesthesiology Physician | 207L00000X | 35403 | SC |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-8908
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451
9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000
990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 835-3560
Hospital & facility affiliations
- Parkwest Medical Center
- Wellmont Holston Valley Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35403 | SC | MD | Anesthesiology Physician |
| 48263 | TN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Anesthesia Group, PC | Anesthesiology | Current | Accepting new patients |
| Paragon Anesthesia PC | Anesthesiology | Current | Accepting new patients |
| East Tennessee Ambulatory Surgery Center LLC | Current | Accepting new patients | |
| American Anesthesiology of Tennessee, P.C. | Anesthesiology | Current | Accepting new patients |
| American Anesthesiology of Tennessee, P.C. | Past | Accepting new patients | |
| Singing River Health System | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
1819 Clinch Ave
Ste 206
Knoxville, TN 37916
Phone (865) 522-2949
501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
9430 Park West Blvd
Ste 210
Knoxville, TN 37923
Phone (865) 531-0494
1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111
210 Fort Sanders West Blvd
Ste 200
Knoxville, TN 37922
Phone (865) 531-5222
Dept 888089
Knoxville, TN 37995
550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000
990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Oak Ridge, TN
- NPI 1639148117
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1538174974
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- Ambulatory Surgical Clinic/Center
- Johnson City, TN
- NPI 1659360071
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1245279777
-
- Internal Medicine Physician
- Pascagoula, MS
- NPI 1134283419
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Knoxville, TN
- NPI 1396739165
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1053577841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461",
"telephone_number": "843-792-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258908",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLLIS",
"first_name": "JEFFREY",
"middle_name": "ALLEN",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-01",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TN",
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TN",
"license": "48263",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "35403",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.