Bruce Devin Gilliland, O.D.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

1593 Issued in TN

Practice address

715 Callahan Dr
Knoxville, TN 37912-1302

Phone

(865) 687-1232

Fax

(865) 687-8256

NPI assigned

Jul 11, 2005

Last updated

Jun 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyexcel, PLLCGroup PAC ID 4688764012, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyexcel, PLLC

  dba EyeXcel

  • Optometrist
  • Knoxville, TN
  • NPI 1962683573
  Medicare reassignment Care Compare group NPD
• Low Vision Center, Inc.

  • Low Vision Rehabilitation Optometrist
  • Knoxville, TN
  • NPI 1972773349
  NPD (past) Authorized official
• Eyexcel, PLLC

  dba EyeXcel Hardin Valley

  • Optometrist
  • Knoxville, TN
  • NPI 1972134997

  Low Vision Rehabilitation

  NPD
• Anesthesiology Consultants Exchange, PC

  • Anesthesiology Physician
  • Chattanooga, TN
  • NPI 1184670218
  NPD (past)
• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Knoxville, TN
  • NPI 1932200664
  NPD (past)
• Southeastern Retina Associates, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Kingsport, TN
  • NPI 1932370145
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1184622441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CALLAHAN DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379121302",
            "telephone_number": "865-687-1232",
            "fax_number": "865-687-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CALLAHAN DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379121302",
            "telephone_number": "865-687-1232",
            "fax_number": "865-687-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "BRUCE",
        "middle_name": "DEVIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TN",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00317714",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILED",
            "identifier": "4102823",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3941143",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77620342",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010168864",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorsie N Gilliam
• Erica Gilliam
• Lisa L. Gilliam, PT
• Andrew Gilligan, DPT
• Lindsay Gilligan, NP
• Jesse Fillin Gilliland
• Madison Gilliland
• Traci T Gilliland, PHARM D
• Bethany Gillis, NP
• Devin Gillis

• Low Vision Rehabilitation Optometrist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Low Vision Rehabilitation Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.