Individual provider Active NPI

Forrest Landon Sherrill, O.D.

  • Optometrist
  • Oak Ridge, TN
National Provider Identifier
1194105403
Registry record updated Jun 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3224 Issued in TN
Practice address
373 S Illinois Ave
Oak Ridge, TN 37830-6741
Phone
(865) 224-6434
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3224 TN Primary

Addresses

Primary practice location

373 S Illinois Ave
Oak Ridge, TN 37830-6741

Mailing address

524 Riverside Dr
Clinton, TN 37716-3427
Phone (901) 356-2032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151116000913 GA Practitioner - Optometry 1759691132
I20151117000043 TN Practitioner - Optometry 1759691132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

373 S Illinois Ave
Oak Ridge, TN 37830-6741
Phone (865) 224-6434

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3224TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sherrill Family Eyecare, PLLC Optometrist CurrentSince Oct 5, 2015 Accepting new patients

Locations

373 S Illinois Ave
Oak Ridge, TN 37830
Phone (865) 224-6434

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1194105403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 RIVERSIDE DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163427",
            "telephone_number": "901-356-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 S ILLINOIS AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306741",
            "telephone_number": "865-224-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRILL",
        "first_name": "FORREST",
        "middle_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.