Elick Jan Combs III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3594 Issued in TN

Practice address

221 E Emory Rd Ste 103
Powell, TN 37849-4061

Phone

(865) 584-0905

Fax

(865) 584-3892

NPI assigned

May 25, 2020

Last updated

Dec 7, 2022By 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 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, 2020

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: ecombs@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Campbell Cunningham Taylor PC

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

  dba Campbell, Cunningham, & Taylor Optical Dispensary

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1902008162
  NPD

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1205459377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E WEISGARBER RD STE 100",
            "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": "221 E EMORY RD STE 103",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378494061",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 E Weisgarber Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379092686",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10841 Hardin Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379321410",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Winfield Dunn Pkwy Unit 120",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378765566",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "962 Dolly Parton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378623707",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12744 Kingston Pike Ste 108",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379340941",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4829 N Broadway St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379182067",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4613 Papermill Dr",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379091971",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "628 Smithview Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378036100",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Keller Ln",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378016201",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "437 S Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378307510",
            "country_code": "US",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMBS",
        "first_name": "ELICK",
        "middle_name": "JAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-25",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q057803",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Mantell Clark, DDS
• Lauren L. Clear, PA
• Taylor Scott Clement, C.P.N.P
• Laura Cockerham, RN
• Molly Ann Coker, APN
• Benjamin Lee Conaway, ATC
• Johnson Yates Congleton, MD
• Lee Congleton III, M.D.
• Sabrina Irene Conklin, DSW, LCSW
• Jordan Elizabeth Cooke, APN

• Optometrist in Powell, TN
• Providers in Powell, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.