NPIMap

Organization Active NPI

Bonnie Shubert OD LLC

  • Optometrist
  • Kansas City, MO
National Provider Identifier
1295208338
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BONNIE SHUBERT OD LLC
Doing business as
Bonnie Shubert OD LLC
Practice address
5110 N Oak Trfy
Kansas City, MO 64118-4621
Phone
(816) 459-7633
Fax
(816) 454-0681
NPI assigned
Jan 10, 2019
Last updated
May 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Bonnie Shubert Large, ODNPI 1538190400
Title
Owner
Phone
(913) 669-6665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5110 N Oak Trfy
Kansas City, MO 64118-4621

Mailing address

14509 Robinson St
Overland Park, KS 66223-1236
Phone (913) 669-6665

Other identifiers 1

IdentifierTypeStateIssuer
NPIOtherKS1538190400

Other names 1

  • BONNIE SHUBERT OD LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1295208338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14509 ROBINSON ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662231236",
            "telephone_number": "913-669-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184621",
            "telephone_number": "816-459-7633",
            "fax_number": "816-454-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE SHUBERT OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "LARGE",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "SHUBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-669-6665",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1538190400",
            "identifier": "NPI",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BONNIE SHUBERT OD LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BONNIE SHUBERT OD LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.