Individual provider Active NPI

Thea T. Shearer, O.D.

  • Optometrist
  • Richmond, KY
National Provider Identifier
1073514204
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1478DT Issued in KY
Practice address
5019 Atwood Dr
Richmond, KY 40475-8898
Phone
(859) 624-2015
Fax
(859) 624-4415
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1478DT KY Primary

Addresses

Primary practice location

5019 Atwood Dr
Richmond, KY 40475-8898

Mailing address

5019 Atwood Dr
Richmond, KY 40475-8898
Phone (859) 624-2015

Other identifiers 3

IdentifierTypeStateIssuer
77000388MedicaidKY
000000195501OtherKYANTHEM
OP0933OtherKYEYE MED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040518000874 KY Practitioner - Optometry 7719977909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5019 Atwood Dr
Richmond, KY 40475-8898
Phone (859) 624-2015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1478DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thea T. Shearer, OD Optometrist CurrentSince Sep 14, 2009 Accepting new patients
Mar-Tan Family Vision Center PastSince Jan 1, 1990 Accepting new patients
Randall C Lambirth II OD & Associates PSC Optometrist Past Accepting new patients
Baptist Healthcare System Inc Past Accepting new patients
Dr Polly Hendricks & Associates, LLC Optometrist PastSince Dec 1, 2008 Accepting new patients

Locations

5019 Atwood Dr
Richmond, KY 40475
Phone (589) 624-2015

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1073514204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 ATWOOD DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758898",
            "telephone_number": "859-624-2015",
            "fax_number": "859-624-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 ATWOOD DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758898",
            "telephone_number": "859-624-2015",
            "fax_number": "859-624-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "THEA",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1478DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77000388",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000195501",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "OP0933",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

Verify at the official NPI Registry.