Active NPI
Shannon Boone, O.D.
- Optometrist
- Lincoln, NE
National Provider Identifier
1174835391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1323
- Practice address
- 3415 E Pershing Rd
Lincoln, NE 68502-4836 - Phone
- (402) 826-9278
- NPI assigned
- Jul 2, 2010
- Last updated
- May 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2728 | CO | |
| Optometrist | 152W00000X | 1323 | NE | Primary |
Addresses
Primary practice location
3415 E Pershing Rd
Lincoln, NE 68502-4836
Mailing address
3415 E Pershing Rd
Lincoln, NE 68502-4836
Phone (402) 826-9278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2728 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1174835391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 E PERSHING RD",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685024836",
"telephone_number": "402-826-9278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 E PERSHING RD",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685024836",
"telephone_number": "402-826-9278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOONE",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-02",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "2728",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NE",
"license": "1323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.