NPIMap

Organization Active NPI

Campbell Cunningham Taylor PC

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
National Provider Identifier
1902008162
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
645010002 Issued in TN
Legal business name
CAMPBELL CUNNINGHAM TAYLOR PC
Practice address
1124 E Weisgarber Rd
Suite 102
Knoxville, TN 37909-2686
Phone
(865) 584-0905
Fax
(865) 584-3892
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Authorized official

Name
Mrs. Rhonda Michelle Garrison
Title
Credentialing Coord.
Phone
(865) 584-2127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 645010002 TN Primary

Addresses

Primary practice location

1124 E Weisgarber Rd
Suite 102
Knoxville, TN 37909-2686

Mailing address

1124 E Weisgarber Rd
Suite 102
Knoxville, TN 37909-2686
Phone (865) 584-0905

Other identifiers 1

IdentifierTypeStateIssuer
3371152MedicaidTN

Other names 1

  • Campbell, Cunningham, & Taylor Optical Dispensary Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930026950 TN DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 0244216562 Practice locations: Knoxville, TN

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Campbell Cunningham Taylor PC1124 E Weisgarber Rd, Knoxville, TN 37909-26868655840905605 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Apr 1, 1990

National Provider Directory

National Provider Directory
Tax ID family
Campbell Cunningham Tay5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1124 E Weisgarber Rd
Ste 100
Knoxville, TN 37909
Phone 8655840905322

10841 Hardin Valley Rd
Knoxville, TN 37932
Phone (865) 584-0900

9430 S Northshore Dr
Knoxville, TN 37922
Phone (865) 862-4260

8445 Walbrook Dr
Knoxville, TN 37923
Phone (865) 548-0620

4829 N Broadway St
Ste 103
Knoxville, TN 37918
Phone (865) 584-2127

104 Keller Ln
Maryville, TN 37801
Phone (865) 681-3937

614 Smithview Dr
Maryville, TN 37803
Phone (865) 984-7012

1751 W Morris Blvd
Morristown, TN 37813

437 S Illinois Ave
Oak Ridge, TN 37830

750 Winfield Dunn Pkwy
Unit 120
Sevierville, TN 37876
Phone (865) 280-1165

115 N Main St
Sweetwater, TN 37874
Phone (423) 337-7040

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1902008162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 E WEISGARBER RD",
            "address_2": "SUITE 102",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092686",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 E WEISGARBER RD",
            "address_2": "SUITE 102",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092686",
            "telephone_number": "865-584-0905",
            "fax_number": "865-584-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL CUNNINGHAM TAYLOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING COORD.",
        "authorized_official_telephone_number": "865-584-2127",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "645010002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3371152",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell, Cunningham, & Taylor Optical Dispensary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Campbell, Cunningham, & Taylor Optical Dispensary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.