Individual provider Active NPI

Donna G Shepard, O.D.

  • Optometrist
  • Austin, TX
National Provider Identifier
1043209612
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3985T Issued in TX
Practice address
11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097
Phone
(512) 343-0406
Fax
(512) 343-1093
NPI assigned
Oct 17, 2005
Last updated
Jun 4, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3985T TX Primary

Addresses

Primary practice location

11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097

Mailing address

11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097
Phone (512) 343-0406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20130926000174 TX Practitioner - Optometry 8426219189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven and Donna ShepardGroup PAC ID 5890956551, 2 clinicians

Practice addresses (Care Compare)

11410 Jollyville Rd
Suite 3201
Austin, TX 78759-2423
Phone (512) 343-0486

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3985TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven & Donna Shepard Optometrist CurrentSince Jan 21, 2000 Accepting new patients

Locations

11410 Jollyville Rd
Ste 3201
Austin, TX 78759
Phone (512) 343-0406

Organizations & group practices 1

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1043209612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 JOLLYVILLE RD",
            "address_2": "SUITE 3201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594097",
            "telephone_number": "512-343-0406",
            "fax_number": "512-343-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 JOLLYVILLE RD",
            "address_2": "SUITE 3201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594097",
            "telephone_number": "512-343-0406",
            "fax_number": "512-343-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "DONNA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3985T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.