Individual provider Active NPI

Frederick Adrian Shinners Jr., OD

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1316916075
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1149 Issued in SC
Practice address
1308 Theater Dr
Mt, Pleasant Towne Centre
Mt Pleasant, SC 29464-3398
Phone
(843) 216-1338
Fax
(843) 216-1487
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1149 SC Primary

Addresses

Primary practice location

1308 Theater Dr
Mt, Pleasant Towne Centre
Mt Pleasant, SC 29464-3398

Mailing address

1308 Theater Dr
Mt, Pleasant Towne Centre
Mt Pleasant, SC 29464-3398
Phone (843) 216-1338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000270 SC Practitioner - Optometry 0446422554 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1149SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
F Mason Smith Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1316916075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 THEATER DR",
            "address_2": "MT, PLEASANT TOWNE CENTRE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643398",
            "telephone_number": "843-216-1338",
            "fax_number": "843-216-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 THEATER DR",
            "address_2": "MT, PLEASANT TOWNE CENTRE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643398",
            "telephone_number": "843-216-1338",
            "fax_number": "843-216-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNERS",
        "first_name": "FREDERICK",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.