Organization Active NPI

Optimal Medical PLLC

  • General Practice Physician
  • Knoxville, TN
National Provider Identifier
1689354284
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMAL MEDICAL PLLC
Practice address
8906 Kingston Pike
Knoxville, TN 37923-5003
Phone
(865) 474-7026
NPI assigned
Jul 19, 2023
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Ashley Wilder
Title
Credentialing Manager
Phone
(865) 803-3188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

8906 Kingston Pike
Knoxville, TN 37923-5003

Mailing address

8906 Kingston Pike
Knoxville, TN 37923-5003
Phone (865) 690-4200

Other practice location 1

2905 Tazewell Pike
Knoxville, TN 37918-1874
Phone (865) 474-7026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231206001761 TN Part B Supplier - Clinic/Group Practice 6103275987 Receives reassigned benefits from 8 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1689354284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235003",
            "telephone_number": "865-690-4200",
            "fax_number": "865-357-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235003",
            "telephone_number": "865-474-7026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2905 Tazewell Pike",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379181874",
            "country_code": "US",
            "telephone_number": "865-474-7026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "865-803-3188"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.