Organization Active NPI

John P Sheldon OD PA

  • Optometrist
  • Marathon, FL
National Provider Identifier
1093830630
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3277 Issued in FL
Legal business name
JOHN P SHELDON OD PA
Practice address
6400 Overseas Hwy
Marathon, FL 33050-2786
Phone
(305) 743-2020
Fax
(395) 743-3937
NPI assigned
Mar 20, 2007
Last updated
Oct 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Dr. John Patrick Sheldon, O.D.NPI 1952596835
Title
President
Phone
(305) 743-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 3277 FL Primary

Addresses

Primary practice location

6400 Overseas Hwy
Marathon, FL 33050-2786

Mailing address

6400 Overseas Hwy
Marathon, FL 33050-2786
Phone (305) 743-2020

Other identifiers 1

IdentifierTypeStateIssuer
620524100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051008000074 FL Part B Supplier - Clinic/Group Practice 4981629946 Receives reassigned benefits from 1 practitioner
Practice locations: Marathon, FL

National Provider Directory

National Provider Directory

Locations

6400 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-2020

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1093830630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 OVERSEAS HWY",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "330502786",
            "telephone_number": "305-743-2020",
            "fax_number": "395-743-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 OVERSEAS HWY",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "330502786",
            "telephone_number": "305-743-2020",
            "fax_number": "395-743-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P SHELDON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "SHELDON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-743-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620524100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marathon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.