Charles Allyn Hildebrand, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD1240 Issued in TN

Practice address

1124 E Weisgarber Rd
Ste 104
Knoxville, TN 37909

Phone

(865) 584-0905

Fax

(865) 584-3892

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Cunningham Taylor PCGroup PAC ID 0244216562, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.31 of 100Reported as group

Quality

97.97

Promoting interoperability

85

Improvement activities

40

Cost

78.9

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: childebrand@ccth.intellechartdirect.net

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.

• Campbell Cunningham Taylor PC

  • Optometrist
  • Knoxville, TN
  • NPI 1407850944
  Medicare reassignment Care Compare group NPD
• Campbell Cunningham Taylor PC

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1902008162
  NPD
• Campbell Cunningham & Taylor, PC

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1811224348
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1194729624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E WEISGARBER RD",
            "address_2": "STE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092686",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E WEISGARBER RD",
            "address_2": "STE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "CHARLES",
        "middle_name": "ALLYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "OD01240",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD1240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3371152",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• High Risk Obstetrical Consultants, PLLC
• David High
• William Ross High Sr., D.M.D.
• Derek Patrick Hight
• Shea Graves Hightower, LMFT
• Gina Maria Hildreth
• Virginia Stafford Hile, P.N.P.
• Mandy Hileman, NP
• Olivia Huggins Hilerio
• Hill-Rom Company, Inc.

• 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 Aug 30, 2018; 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.