Individual provider Active NPI

Nolan Harrison Shenk

  • Optometrist
  • Lebanon, PA
National Provider Identifier
1083597702
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG004308 Issued in PA
Practice address
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Phone
(717) 272-6621
Fax
(717) 228-5977
NPI assigned
Jul 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004308 PA Primary

Addresses

Primary practice location

1700 S Lincoln Ave
Lebanon, PA 17042-7529

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

2791 S Queen St
Dallastown, PA 17313-9540
Phone (717) 741-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251008000423 PA Practitioner - Optometry 9537666458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

125 S Antrim Way
Greencastle, PA 17225-1521
Phone (717) 597-4780

2791 S Queen St
Dallastown, PA 17313-9540
Phone (717) 741-4788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients

Locations

2791 S Queen St
Dallastown, PA 17313
Phone (717) 741-4788

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

1304 Baltimore St
Hanover, PA 17331
Phone (717) 632-8600

2842 S Eagle Rd
Newtown, PA 18940
Phone (215) 579-1155

2155 White St
York, PA 17404
Phone (717) 848-4654

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1083597702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2791 S Queen St",
            "address_purpose": "LOCATION",
            "city": "Dallastown",
            "state": "PA",
            "postal_code": "173139540",
            "country_code": "US",
            "telephone_number": "717-741-4788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENK",
        "first_name": "NOLAN",
        "middle_name": "HARRISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-29",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.