Individual provider Active NPI

Thomas R Shelor, OD PA

  • Optometrist
  • Olathe, KS
National Provider Identifier
1215964770
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1075-2 Issued in KS
Practice address
401 S Clairborne Rd
Ste B
Olathe, KS 66062-1735
Phone
(913) 782-1213
Fax
(913) 782-4801
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1075-2 KS Primary

Addresses

Primary practice location

401 S Clairborne Rd
Ste B
Olathe, KS 66062-1735

Mailing address

401 S Clairborne Rd
Ste B
Olathe, KS 66062-1735
Phone (913) 782-1213

Other identifiers 2

IdentifierTypeStateIssuer
4526530001OtherKSCIGNA MEDICARE DMERC
04524021OtherKSBC BS OF KC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1075-2KSMDOptometrist
10752KSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas R Shelor OD PA Optometrist PastSince Jul 1, 2002 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1215964770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S CLAIRBORNE RD",
            "address_2": "STE B",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621735",
            "telephone_number": "913-782-1213",
            "fax_number": "913-782-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S CLAIRBORNE RD",
            "address_2": "STE B",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621735",
            "telephone_number": "913-782-1213",
            "fax_number": "913-782-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELOR",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "OD PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1075-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DMERC",
            "identifier": "4526530001",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF KC",
            "identifier": "04524021",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.