Knoxville Pediatric Ophthalmology, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

14247 Issued in TN

Legal business name

KNOXVILLE PEDIATRIC OPHTHALMOLOGY, PLLC

Practice address

2100 W Clinch Ave
Suite 400 Koppel Plaza
Knoxville, TN 37916-2219

Phone

(865) 521-7998

Fax

(865) 521-7405

NPI assigned

Sep 15, 2010

Last updated

Aug 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deborah F Stoffle

Title

Office Admin

Phone

(865) 521-7998

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Roddy Maisonville, OD

  • Optometrist
  • Knoxville, TN
  • NPI 1215550439
  Medicare reassignment NPD
• Allyson D Schmitt, M.D.

  • Ophthalmology Physician
  • Knoxville, TN
  • NPI 1457402216
  Medicare reassignment NPD

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1174831887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W CLINCH AVE",
            "address_2": "SUITE 400 KOPPEL PLAZA",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162219",
            "telephone_number": "865-521-7998",
            "fax_number": "865-521-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W CLINCH AVE",
            "address_2": "SUITE 400 KOPPEL PLAZA",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162219",
            "telephone_number": "865-521-7998",
            "fax_number": "865-521-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE PEDIATRIC OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "STOFFLE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "865-521-7998"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "14247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3196142",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Knoxville Pathology Consultants PC
• Knoxville Pediatric Associates, P.C.
• Knoxville Pediatric Dentistry, PLLC
• Knoxville Pediatric Dentistry, PLLC
• Knoxville Pediatric Dentistry, PLLC
• Knoxville Periodontics, P.C.
• Knoxville Physical Therapy, Inc.
• Knoxville Psychiatric Group
• Knoxville Psychological Center, PLLC
• Knoxville Pulmonary Group, P.a.

• Ophthalmology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.