Individual provider Active NPI

Shelby Yvonne Davis, LDO

  • Optician
  • Kennewick, WA
National Provider Identifier
1013609791
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
2720 S Quillan St
Kennewick, WA 99337-2404
Phone
(509) 585-8314
Fax
(509) 585-9653
NPI assigned
May 22, 2023
Last updated
May 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X WA Primary

Addresses

Primary practice location

2720 S Quillan St
Kennewick, WA 99337-2404

Mailing address

47504 N 108 PR NW
Benton City, WA 99320-6690
Phone (541) 786-5120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1013609791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47504 N 108 PR NW",
            "city": "BENTON CITY",
            "state": "WA",
            "postal_code": "993206690",
            "telephone_number": "541-786-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 S QUILLAN ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372404",
            "telephone_number": "509-585-8314",
            "fax_number": "509-585-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHELBY",
        "middle_name": "YVONNE",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.