Individual provider Active NPI

Emily R Shull, O.D.

  • Optometrist
  • Cincinnati, OH
National Provider Identifier
1003836412
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5574 T2488 Issued in OH
Practice address
500 Wyoming Ave
Cincinnati, OH 45215-4422
Phone
(513) 821-1200
Fax
(513) 821-2400
NPI assigned
Jul 20, 2006
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5574 T2488 OH Primary

Addresses

Primary practice location

500 Wyoming Ave
Cincinnati, OH 45215-4422

Mailing address

500 Wyoming Ave
Cincinnati, OH 45215-4422
Phone (513) 821-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051214000000 OH Practitioner - Optometry 4981625316 Reassigns benefits to 2 organizations
I20070717000611 KY Practitioner - Optometry 4981625316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Wyoming Ave
Cincinnati, OH 45215-4422
Phone (513) 821-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cei Physicians PSC LLC CurrentSince Aug 1, 2006 Accepting new patients
Sight, LLC Optometrist CurrentSince Aug 20, 2013 Accepting new patients
Cei Physicians PSC, LLC CurrentSince Aug 1, 2006 Accepting new patients
Cei Physicians PSC LLC Optometrist CurrentSince Aug 1, 2006 Accepting new patients

Locations

580 S Loop Rd
Ste 200
Edgewood, KY 41017
Phone (859) 331-9000

1945 Cei Dr
Blue Ash, OH 45242

500 Wyoming Ave
Wyoming, OH 45215
Phone (513) 821-1200

Networks

  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • OH PPO

Interoperability endpoints

  • Direct secure messaging: emily.shull.p1@direct.cei.nextgenshare.com

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1003836412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WYOMING AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452154422",
            "telephone_number": "513-821-1200",
            "fax_number": "513-821-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WYOMING AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452154422",
            "telephone_number": "513-821-1200",
            "fax_number": "513-821-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "EMILY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5574 T2488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.