Windham Family Eye Care PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0766 Issued in NH

Legal business name

WINDHAM FAMILY EYE CARE PLLC

Practice address

63 Range Rd
Suite 104
Windham, NH 03087-2098

Phone

(603) 318-9108

NPI assigned

Dec 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Marie Shanley, ODNPI 1437162963

Title

Optometrist

Phone

(603) 318-9108

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Jennifer Marie Shanley, O.D.

  • Optometrist
  • Windham, NH
  • NPI 1437162963
  NPD (past) Authorized official

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134285372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 RANGE RD",
            "address_2": "SUITE 104",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030872098",
            "telephone_number": "603-318-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 RANGE RD",
            "address_2": "SUITE 104",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030872098",
            "telephone_number": "603-318-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM FAMILY EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANLEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "603-318-9108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437162963",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30354446",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Wilkinson, REGISTERED NURSE
• Corey David Williams
• Donna Willis
• Windham Dental Center
• Windham Dental Group, PLLC
• Windham Kids Pediatric Dentistry, PLLC
• Windham School District
• Kathleen M Wood Bacon, LICSW
• Maureen Woodard, MS OTR/L
• Richard A. Workman, D.M.D.

• Optometrist in Windham, NH
• Providers in Windham, NH by specialty
• Optometrist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.