NPIMap

Organization Active NPI

Shorewood Opticians

  • Eyewear Supplier
  • Milwaukee, WI
National Provider Identifier
1053447474
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SHOREWOOD OPTICIANS
Practice address
5150 N Port Washington Rd
#251
Milwaukee, WI 53217-5474
Phone
(414) 332-0606
Fax
(414) 967-3604
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kenneth S Fabric, M.D.NPI 1699728659
Title
President
Phone
(414) 332-0606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

5150 N Port Washington Rd
#251
Milwaukee, WI 53217-5474

Mailing address

5150 N Port Washington Rd
#251
Milwaukee, WI 53217-5474
Phone (414) 332-0606

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053447474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "#251",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-332-0606",
            "fax_number": "414-967-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD",
            "address_2": "#251",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175474",
            "telephone_number": "414-332-0606",
            "fax_number": "414-967-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREWOOD OPTICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FABRIC",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-332-0606",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.