Roger F Shaw III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

754-055T Issued in LA

Practice address

23855 Eden St
Plaquemine, LA 70764-3315

Phone

(225) 687-4190

Fax

(225) 687-2000

NPI assigned

Oct 4, 2006

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Roger F. Shaw, III Apmc

  dba Southern Eye Center

  • Optometrist
  • Baton Rouge, LA
  • NPI 1003009499
  NPD Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1083709760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23855 EDEN ST",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707643315",
            "telephone_number": "225-687-4190",
            "fax_number": "225-687-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23855 EDEN ST",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707643315",
            "telephone_number": "225-687-4190",
            "fax_number": "225-687-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROGER",
        "middle_name": "F",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "754-055T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1151955",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy M Salvadras, N/A
• Megan Dolhonde Sarradet, MOT, LOTR
• Jason Schrock, M.D.
• Segura Psychiatric Services
• Ann Hardin Shaw, OD, MS
• Signs & Wonders Community Mental Health Center LLC (southeast professional health group llc)
• Latreshia Simon
• Arwinderpal Singh, PHARMD
• Katherine Smiles
• Eleanor Smith

• Optometrist in Plaquemine, LA
• Providers in Plaquemine, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.