C Eric Shrader

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0418471 Issued in KS

Practice address

655 N Woodlawn
Wichita, KS 67208

Phone

(316) 684-5158

Fax

(316) 858-3830

NPI assigned

Feb 27, 2006

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

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Grene Vision Group LLC

  • Ophthalmology Physician
  • Wichita, KS
  • NPI 1285627562
  Medicare reassignment NPD
• Grene Vision Group LLC

  • Optometrist
  • Wichita, KS
  • NPI 1598215006

  Ophthalmology

  NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1093781320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "address_2": "ATTN FLR2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-636-2010",
            "fax_number": "316-858-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N WOODLAWN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "316-684-5158",
            "fax_number": "316-858-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRADER",
        "first_name": "C",
        "middle_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "0418471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheyanne Michelle Shorb
• Joanna Lee Short, LMSW
• Julie Cecile Short, APRN
• Levi Curtis Short, MD
• Gena Sue Shorter, LSCSW
• Clinton Shriner, PA-C
• Sarah M Shriner
• Madalyn Bridget Slieter Shriver, LMFT
• Toni Rae Shroyer, OTR/L
• Lucas Shryock, LPC

• Ophthalmology Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Ophthalmology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.