Individual provider Active NPI

Jenna Nichole O'Shields, LDO,NCLE,ABOC

  • Optician
  • Greer, SC
National Provider Identifier
1043940331
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1102 Issued in SC
Practice address
14055 E Wade Hampton Blvd
Greer, SC 29651-1500
Phone
(864) 877-5248
Fax
(864) 877-3174
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1102 SC Primary

Addresses

Primary practice location

14055 E Wade Hampton Blvd
Greer, SC 29651-1500

Mailing address

14055 E Wade Hampton Blvd
Greer, SC 29651-1500
Phone (864) 877-5248

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

State licenses

LicenseStateTypeSpecialty
1102SCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1043940331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14055 E WADE HAMPTON BLVD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511500",
            "telephone_number": "864-877-5248",
            "fax_number": "864-877-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14055 E WADE HAMPTON BLVD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511500",
            "telephone_number": "864-877-5248",
            "fax_number": "864-877-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHIELDS",
        "first_name": "JENNA",
        "middle_name": "NICHOLE",
        "credential": "LDO,NCLE,ABOC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.