Arthur H Ellis III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD0000000613 Issued in TN

Practice address

140 Peachtree PLZ
Brownsville, TN 38012-2500

Phone

(731) 772-2020

Fax

(731) 772-3954

NPI assigned

Aug 8, 2006

Last updated

Mar 5, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Professional Eyecare Associates and Optical PLLC

  • Optometrist
  • Humboldt, TN
  • NPI 1386821981
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1811907561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PEACHTREE PLZ",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380122500",
            "telephone_number": "731-772-2020",
            "fax_number": "731-772-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PEACHTREE PLZ",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380122500",
            "telephone_number": "731-772-2020",
            "fax_number": "731-772-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ARTHUR",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000000613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0149285",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00270315",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3593820",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dyersburg Clinic Corp (Haywood Park Urgent Care)
• Adam P English, D.O.
• Susan B Esquivias
• Faith Family Medical Clinic, LLC
• Fast Pace Medical Clinic PLLC
• Katherine Finan, M.S., R.D., L.D.N.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.