Evans Eye Care Corp

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EVANS EYE CARE CORP

Practice address

1711 NE 163Rd St
North Miami Beach, FL 33162-4732

Phone

(302) 670-4096

Fax

(305) 949-7301

NPI assigned

Sep 18, 2018

Last updated

Oct 24, 2018By 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. Shannon Evans, ODNPI 1205184488

Title

Optometrist

Phone

(302) 670-4096

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Shannon Marie Evans, O.D.

  • Optometrist
  • North Miami Beach, FL
  • NPI 1205184488
  Authorized official Same address or phone

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1255815064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 NW 207TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293506",
            "telephone_number": "302-670-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624732",
            "telephone_number": "302-670-4096",
            "fax_number": "305-949-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS EYE CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "302-670-4096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014059500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwina Etienne, ARNP
• Eureka Chiropractic Center, LLC
• Tynesha L Eutsay
• Evan Mehlman PHD P.a.
• Wayne Nicholas Evancho, DO
• Shannon Marie Evans, O.D.
• Executive Medical Group LLC
• Executive Medical Physics Associates, LLC
• Exelsior Diagnostic Service, Inc.
• Exelsior Medical Group, Inc.

• Optometrist in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.