Individual provider Active NPI

Hilary C. Grissom, M.D.

  • Ophthalmology Physician
  • Jackson, TN
National Provider Identifier
1124241997
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
43415 Issued in TN
Practice address
668 Skyline Dr
Jackson, TN 38301
Phone
(731) 424-2414
Fax
(731) 424-4444
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 43415 TN Primary

Addresses

Primary practice location

668 Skyline Dr
Jackson, TN 38301

Mailing address

668 Skyline Drive
Jackson, TN 38301
Phone (731) 424-2414

Other names 1

  • Mrs. Hilary C. Grissom Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000553 TN Practitioner - Ophthalmology 5294800751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Tennessee, HSC, College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skyline Eye Clinic, PCGroup PAC ID 0042253882, 9 clinicians

Practice addresses (Care Compare)

1340 Union University Dr
Jackson, TN 38305-3780
Phone (731) 424-2414

668 Skyline Dr
Jackson, TN 38301-3951
Phone (731) 426-8434

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Merit-based Incentive Payment System (MIPS)

Final score
92.16 of 100Reported as group
Quality
97.83
Improvement activities
40
Cost
76.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43415TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Eye Clinic, PC Ophthalmology CurrentSince Aug 5, 2008 Accepting new patients
Advanced Cardiovascular & Vein Center PastSince Nov 23, 2009 Accepting new patients

Locations

138 S Washington Ave
Henderson, TN 38340
Phone (731) 989-3511

1340 Union University Dr
Jackson, TN 38305
Phone (731) 215-1281

668 Skyline Dr
Jackson, TN 38301
Phone (731) 424-1414

Interoperability endpoints

  • Direct secure messaging: hgrissom@ecpc.intellechartdirect.net
  • FHIR API: https://api.platform.athenahealth.com/14790/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1124241997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-424-2414",
            "fax_number": "731-424-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-424-2414",
            "fax_number": "731-424-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "HILARY",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "43415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HILARY",
            "last_name": "GRISSOM",
            "middle_name": "C.",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.