Individual provider Active NPI

Shelleigh McVicker Buckingham, O.D.

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1164590659
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S951TA530 Issued in AL
Practice address
1716 University Blvd
G080A
Birmingham, AL 35294-0010
Phone
(205) 975-2020
Fax
(205) 975-8281
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S951TA530 AL Primary

Addresses

Primary practice location

1716 University Blvd
G080A
Birmingham, AL 35294-0010

Mailing address

1716 University Blvd G080A
Birmingham, AL 35294-0010
Phone (205) 975-2020

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050315000961 AL Practitioner - Optometry 7911952684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama at BirminghamGroup PAC ID 3779487970, 93 clinicians

Practice addresses (Care Compare)

1716 University Blvd
Birmingham, AL 35233-1816
Phone (205) 934-3899

1720 University Blvd
Birmingham, AL 35233-1816
Phone (205) 731-9050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S951TA530ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Alabama at Birmingham Optometrist CurrentSince Nov 5, 2023 Accepting new patients
St. Clair Eye Care LLC Optometrist CurrentSince Mar 15, 2005 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
St Clair Eye Care LLC Optometrist Current Accepting new patients
University of Alabama at Birmingham CurrentSince Nov 5, 2023 Accepting new patients
Wallace Optometry Associates Optometrist Past Accepting new patients

Locations

1716 University Blvd
#80A
Birmingham, AL 35233

1716 University Blvd
Birmingham, AL 35233
Phone (205) 934-3899

1716 University Blvd
#G80A
Birmingham, AL 35233
Phone (205) 934-4748

1716 University Blvd
Birmingham, AL 35294

2824 Moody Pkwy
Moody, AL 35004
Phone (205) 640-3091

6448 US Highway 11
Springville, AL 35146
Phone (205) 467-7608

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1164590659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-934-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD",
            "address_2": "G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-975-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKINGHAM",
        "first_name": "SHELLEIGH",
        "middle_name": "MCVICKER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S951TA530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.