Shawn Paul Doherty, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

MS511 Issued in MS

Practice address

611 Franklin St
Natchez, MS 39120-3311

Phone

(601) 445-4282

NPI assigned

Oct 26, 2005

Last updated

Apr 22, 2008By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in MS

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doherty Vision Clinic PAGroup PAC ID 4385857929, 2 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doherty Vision Clinic PA

  • Optometrist
  • Natchez, MS
  • NPI 1033285119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1043200553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 FRANKLIN ST",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391203311",
            "telephone_number": "601-445-4282",
            "fax_number": "601-445-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 FRANKLIN ST",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391203311",
            "telephone_number": "601-445-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "SHAWN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "MS511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1466727",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410047920",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880060",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Personal Care
• Dixon Consultants Inc
• Calvin Lionel Dixon, RRT
• Doherty Vision Clinic PA
• Patrick Rowan Doherty, OD
• Carolyn B Dollar, APRN BC, FNP
• Margaret Michelle Donald, LCSW
• Sterling Edward Dossett
• Dr. Sherman Medical Clinic
• Kenneth Sloan Drane, MD

• Optometrist in Natchez, MS
• Providers in Natchez, MS by specialty
• Optometrist in Mississippi

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