Charles Y Shields, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODT1339 Issued in TN

Practice address

10219 Kingston Pike
Ste 101
Knoxville, TN 37922-3222

Phone

(865) 539-3888

Fax

(865) 539-0653

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• DRS. Shields and Shields

  • Optometrist
  • Knoxville, TN
  • NPI 1114085701
  NPD (past) Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1114085859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10219 KINGSTON PIKE",
            "address_2": "STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223222",
            "telephone_number": "865-539-3888",
            "fax_number": "865-539-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10219 KINGSTON PIKE",
            "address_2": "STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223222",
            "telephone_number": "865-539-3888",
            "fax_number": "865-539-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "CHARLES",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "ODT1339",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TN",
            "license": "ODT1339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vance Robert Sherwood, PH.D.
• Sydney Shevat
• Weston James Shew
• Yongmei Shi
• Elizabeth Shieh, FNP
• Crystal Crockett Shields
• Gloria K Shields, MSN, FNP-BC, RN
• Henry Shiflett, D.O.
• Matthew Henry Shih
• Ryan Allen Shillingburg, DO

• Optometrist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.

Verify at the official NPI Registry.