Individual provider Active NPI

Donald Wayne Connell, O.D.

  • Optometrist
  • Knoxville, TN
National Provider Identifier
1790947836
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2805 Issued in TN
Practice address
6719 Maynardville Pike
Knoxville, TN 37918-5348
Phone
(865) 922-3937
Fax
(865) 922-8412
NPI assigned
Jun 30, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2805 TN Primary

Addresses

Primary practice location

6719 Maynardville Pike
Knoxville, TN 37918-5348

Mailing address

6719 Maynardville Pike
Knoxville, TN 37918-5348
Phone (865) 922-3937

Other practice location 1

4300 Chapman Hwy
Knoxville, TN 37920-3058
Phone (865) 577-2020

Other identifiers 1

IdentifierTypeStateIssuer
1522487MedicaidTN

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
I20110407000266 TN Practitioner - Optometry 5597949081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven Elliott OD and Associates IncGroup PAC ID 3577752526, 9 clinicians

Practice addresses (Care Compare)

6719 Maynardville Pike
Knoxville, TN 37918-5308
Phone (865) 377-4141

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2805TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven D. Elliott, O.D. & Associates, Inc. Optometrist Past Accepting new patients
Rogersville Vision Clinic, PLLC Optometrist Past Accepting new patients
Rogersville Vision Clinic,PLLC Optometrist PastSince Jul 24, 2012 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790947836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 MAYNARDVILLE PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379185348",
            "telephone_number": "865-922-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 MAYNARDVILLE PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379185348",
            "telephone_number": "865-922-3937",
            "fax_number": "865-922-8412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Chapman Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379203058",
            "country_code": "US",
            "telephone_number": "865-577-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "DONALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522487",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.