NPIMap

Organization Active NPI

Shippee Family Eye Care PC

Doing business as DBA Optical Expressions

  • Optometrist
  • St Johnsbury, VT
National Provider Identifier
1023407467
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
300000331 Issued in VT
Legal business name
SHIPPEE FAMILY EYE CARE PC
Doing business as
DBA Optical Expressions
Practice address
468 Hospital Dr
St Johnsbury, VT 05819-9225
Phone
(802) 748-3536
Fax
(802) 748-4838
NPI assigned
Jan 22, 2015
Last updated
Sep 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SHIPPEE FAMILY EYE CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Authorized official

Name
Dr. Samuel P Shippee, ODNPI 1508845025
Title
Owner/Authorized Official
Phone
(603) 788-3561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 300000331 VT Primary

Addresses

Primary practice location

468 Hospital Dr
St Johnsbury, VT 05819-9225

Mailing address

468 Hospital Dr
St Johnsbury, VT 05819-9225
Phone (802) 748-3536

Other identifiers 1

IdentifierTypeStateIssuer
1016148MedicaidVT

Other names 1

  • DBA Optical Expressions Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150515000060 VT Part B Supplier - Clinic/Group Practice 4183772239 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Montpelier, VT; Saint Johnsbury, VT
O20150723008207 VT DME Supplier - Physician - Optometrist 4183772239 Practice locations: St Johnsbury, VT

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D2107362Shippee Family Eye Care Dba Optical Expressions468 Hospital Dr, Saint Johnsbury, VT 05819Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Shippee Family Eye Care PC3 organizations share this tax ID, including this one
Part of
Shippee Family Eye Care PC

Other organizations with this tax ID 2

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

Locations

580 Saint Johnsbury Rd
Ste 12
Littleton, NH 03561
Phone (603) 444-2184

Interoperability endpoints

  • Direct secure messaging: sshippee@shippeefamilyeyecare.eyefinity-direct.com

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1023407467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199225",
            "telephone_number": "802-748-3536",
            "fax_number": "802-748-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199225",
            "telephone_number": "802-748-3536",
            "fax_number": "802-748-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIPPEE FAMILY EYE CARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHIPPEE FAMILY EYE CARE",
        "enumeration_date": "2015-01-22",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "SHIPPEE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "603-788-3561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "300000331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016148",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Optical Expressions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DBA Optical Expressions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Johnsbury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.