Shannon Hawkley Mitchell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

030.0068209 Issued in VT

Practice address

5274 Main St Ste 1
Waitsfield, VT 05673-4445

Phone

(802) 448-6988

Fax

(802) 496-9500

NPI assigned

Jan 21, 2010

Last updated

Oct 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

Optometry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mad River Eye Care PLLCGroup PAC ID 9830444009, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

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.

• Mad River Eye Care PLLC

  • Corneal and Contact Management Optometrist
  • Waitsfield, VT
  • NPI 1538666235
  Medicare reassignment Care Compare group NPD Authorized official
• Myeyedr Optometry of Vermont LLC

  dba MyEyeDr.

  • Optometrist
  • Williston, VT
  • NPI 1295245876
  Medicare reassignment NPD
• Myeyedr Optometry of Vermont LLC

  dba MyEyeDr.

  • Optometrist
  • Burlington, VT
  • NPI 1760075345
  NPD

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1144551797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5274 MAIN ST STE 1",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056734445",
            "telephone_number": "802-448-6988",
            "fax_number": "802-496-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5274 MAIN ST STE 1",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056734445",
            "telephone_number": "802-448-6988",
            "fax_number": "802-496-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 S Main St",
            "address_purpose": "LOCATION",
            "city": "Stowe",
            "state": "VT",
            "postal_code": "056724679",
            "country_code": "US",
            "telephone_number": "802-253-6322",
            "fax_number": "802-253-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHANNON",
        "middle_name": "HAWKLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-21",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0068209",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VT",
            "license": "030.0068209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mad River Valley Ambulance Service, Inc.
• Mahoney Family Chiropractic, LLC
• Sean Patrick Mahoney, D.C.
• Morgan McClintic, OD
• Patrick William McManus
• Sarah E Morrison, OTR/L
• Nancy Marie Smyth.
• New Age Chiropractic and Rehab PLLC
• Oppenheimer LLC (Oppenheimer Counseling, Coaching and Guided Immersion Experiences)
• Evan Matthew Oppenheimer, LCMHC

• Optometrist in Waitsfield, VT
• Providers in Waitsfield, VT by specialty
• Optometrist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.