NPIMap

Individual provider Active NPI

Jonathan L Shrewsbury, O.D.

  • Optometrist
  • Beaver Dam, KY
National Provider Identifier
1326050329
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0956DT Issued in KY
Practice address
1303 North Main St.
Beaver Dam, KY 42320
Phone
(270) 274-3294
Fax
(270) 274-4811
NPI assigned
Aug 12, 2006
Last updated
Jun 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0956DT KY Primary

Addresses

Primary practice location

1303 North Main St.
Beaver Dam, KY 42320

Mailing address

1303 North Main Street
Beaver Dam, KY 42320
Phone (270) 274-3294

Other identifiers 1

IdentifierTypeStateIssuer
77009561MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000221 KY Practitioner - Optometry 5193639896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluegrass Family Eyecare Inc.Group PAC ID 3274525290, 2 clinicians

Practice addresses (Care Compare)

1303 N Main St
Beaver Dam, KY 42320-8957
Phone (270) 274-3294

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Family Eyecare Inc. Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Ohio County Hospital Corporation PastSince Jan 1, 1995 Accepting new patients

Locations

1303 N Main St
Beaver Dam, KY 42320
Phone (270) 274-3294

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ohio County Hospital CorporationHartford, KY, CCN 181323 Hospital Corporate Director Jan 1, 1995
Ohio County Hospital CorporationHartford, KY, CCN 18Z323 Hospital Corporate Director Jan 1, 2007
Hospice of Ohio CountyHartford, KY, CCN 181518 Hospice Corporate Director Jan 1, 1995
Fordsville Area Medical ClinicFordsville, KY, CCN 183408 Rural health clinic Corporate Director Jan 1, 1994
Butler County Family CareMorgantown, KY, CCN 183489 Rural health clinic Corporate Director Jan 1, 1995

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1326050329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 NORTH MAIN STREET",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "42320",
            "telephone_number": "270-274-3294",
            "fax_number": "270-274-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 NORTH MAIN ST.",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "42320",
            "telephone_number": "270-274-3294",
            "fax_number": "270-274-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREWSBURY",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0956DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009561",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

Verify at the official NPI Registry.