Timothy B Spicer, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

01486 Issued in TN

Practice address

622 Smithview Dr
Maryville, TN 37803-6100

Phone

(865) 681-1234

Fax

(865) 982-9746

NPI assigned

Mar 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Specialty

Optometry

Education

Southern College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Envision Family Eyecare, PLLCGroup PAC ID 5294989513, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Envision Family Eyecare, PLLC

  • Optometrist
  • Maryville, TN
  • NPI 1043550916

  Corneal and Contact Management

  Medicare reassignment Care Compare group NPD
• Envision Family Eye Care, PLLC

  • Optometrist
  • Maryville, TN
  • NPI 1932396371

  Corneal and Contact Management

  NPD (past)
• University Eye Specialists, PC

  • Ophthalmology Physician
  • Knoxville, TN
  • NPI 1316916158

  Corneal and Contact Management

  NPD (past)
• University Eye Surgeons, P.C.

  • Eyewear Supplier
  • Knoxville, TN
  • NPI 1598772964
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1962471789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 ALCOA HWY",
            "address_2": "SUITE 324",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201502",
            "telephone_number": "865-524-9871",
            "fax_number": "865-305-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 SMITHVIEW DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036100",
            "telephone_number": "865-681-1234",
            "fax_number": "865-982-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "01486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3114334",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3539796",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410038572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3599181",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2240323",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5948070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "100024365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "3333333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Speech Pathology Services of East Tennessee LLC
• Spencer Dental PLLC
• Gregory Thomas Spencer, D.D.S.
• Ronald W Spencer, D.D.S.
• Jennifer Renee Spicer, A.P.N.-B.C.
• Jacob D Spier, FNP-BC
• Coleen Michele Spotts, CRNA
• Ariel P Stakely, FNP-BC
• Martha Stanojevich, MSSW, LCSW
• Starbright Centers TN Opco LLC

• Corneal and Contact Management Optometrist in Maryville, TN
• Providers in Maryville, TN by specialty
• Corneal and Contact Management Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.