Individual provider Active NPI

James Watson Kirkconnell, O.D.

  • Optometrist
  • Gallatin, TN
National Provider Identifier
1467523167
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD2307 Issued in TN
Practice address
137 West Broadway
Gallatin, TN 37066-2717
Phone
(615) 452-2111
Fax
(615) 452-2251
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD0000002307 TN
Optometrist 152W00000X OD2307 TN Primary

Addresses

Primary practice location

137 West Broadway
Gallatin, TN 37066-2717

Mailing address

7640 Hwy 70 South, Ste 102
Nashville, TN 37221-1758
Phone (615) 662-7588

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
I20071121000354 TN Practitioner - Optometry 3971691114 Practice locations: Nashville, TN

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7640 Hwy 70 S
Suite 102
Nashville, TN 37221-1758

7640 Hwy 70 S 102
Nashville, TN 37221-1758
Phone (615) 662-7588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD0000002307TNMDOptometrist
OD2307TNMDOptometrist
2307TNMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1467523167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 HWY 70 SOUTH, STE 102",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372211758",
            "telephone_number": "615-662-7588",
            "fax_number": "615-662-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 WEST BROADWAY",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662717",
            "telephone_number": "615-452-2111",
            "fax_number": "615-452-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKCONNELL",
        "first_name": "JAMES",
        "middle_name": "WATSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000002307",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD2307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.