D Scott Shettle OD PA

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OPC 2753 Issued in FL

Legal business name

D SCOTT SHETTLE OD PA

Practice address

4200 4TH St N
Suite F
St Petersburg, FL 33703-4735

Phone

(727) 528-2015

Fax

(727) 528-2010

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

David Scott Shettle, O.D.NPI 1740280130

Title

Optometrist/Owner/President

Phone

(727) 422-2940

Specialties & licenses 1

Addresses

Other names 1

• Shettle Family Eye Care & Eye Wear Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Scott Shettle, O.D.

  • Optometrist
  • St Petersburg, FL
  • NPI 1740280130
  Medicare reassignment Care Compare group NPD Authorized official
• Logan Scott Shettle, O.D.

  • Optometrist
  • St Petersburg, FL
  • NPI 1417847880
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1265674733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 RIVERSIDE RIDGE RD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346888802",
            "telephone_number": "727-422-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 4TH ST N",
            "address_2": "SUITE F",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337034735",
            "telephone_number": "727-528-2015",
            "fax_number": "727-528-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D SCOTT SHETTLE OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "SHETTLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER/PRESIDENT",
        "authorized_official_telephone_number": "727-422-2940",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "OPC 2753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shettle Family Eye Care & Eye Wear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bianca Jean Cypser
• Alan Cyr, LMHC
• Ashley Cyronak
• Sarah Elizabeth Czack
• D & M Non-Emergency Transport Service LLC
• D. Funsch, M.D. Medical Care, PLLC
• Steven Anthony D'Agostino
• Dutch Greyson D'Amico, D.C.
• Tiffany Lynn D'Angelo, DNP, APRN, FNP-BC
• Crystal Dawn D'Auria

• Eyewear Supplier in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Eyewear Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.