Individual provider Active NPI

Shirley Velasco-Hill, OD

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1427730324
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3831 Issued in TN
Practice address
110 Med Tech Pkwy
Johnson City, TN 37604-4004
Phone
(423) 929-4111
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3831 TN Primary

Addresses

Primary practice location

110 Med Tech Pkwy
Johnson City, TN 37604-4004

Mailing address

PO Box 5820
Johnson City, TN 37602-5820
Phone (423) 737-2041

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231031000740 TN Practitioner - Optometry 0547616310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson City Eye Clinic PCGroup PAC ID 3375448681, 11 clinicians

Practice addresses (Care Compare)

110 Med Tech Pkwy
Suite 1
Johnson City, TN 37604-4004
Phone (423) 929-2111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson City Eye Clinic PC CurrentSince Nov 8, 2023 Accepting new patients

Locations

321 Midway Medical Park
Ste 2
Bristol, TN 37620
Phone (276) 783-5157

110 Med Tech Pkwy
Ste 1
Johnson City, TN 37604
Phone 42372203603507

110 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 722-0340

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": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1427730324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5820",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376025820",
            "telephone_number": "423-737-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044004",
            "telephone_number": "423-929-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO-HILL",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.