Shawn T Sussmane, OD
Optometrist in Knoxville, TN. Individual provider (NPI-1).
NPI number1386644151
StatusActive
Last updated in NPPESMay 24, 2024
Details
- NPI
- 1386644151
- Entity type
- Individual (NPI-1)
- Name
- Shawn T Sussmane
- Credential
- OD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 22, 2005
- Certification date
- May 24, 2024
- Last updated
- May 24, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPC6391 | FL | Yes |
| 152W00000X | Optometrist | TN2032 | TN |
Practice location
1124 E Weisgarber Rd Ste 104Knoxville, TN 37909-2686
Phone 865-584-2127
Mailing address
Po Box 100284Gainesville, FL 32610-0284
Phone 352-273-8778 · Fax 352-273-7402
Other practice locations
104 Keller Ln
Maryville, TN 37801-6201
Maryville, TN 37801-6201
Phone 865-681-3937 · Fax 865-681-3422
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 145 Optometrist providers in Knoxville · All 17,212 providers in Knoxville
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