Organization Active NPI

Yvonne T. Shook O.D.P.a.

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1336415579
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1355 Issued in NC
Legal business name
YVONNE T. SHOOK O.D.P.A.
Practice address
1433 Emerywood Dr
Suite C
Charlotte, NC 28210-4105
Phone
(704) 553-2020
NPI assigned
Mar 30, 2012
Last updated
Mar 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Dr. Yvonne T Shook, O.D.NPI 1194830901
Title
Optometrist
Phone
(704) 553-2020

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
Optometrist 152W00000X NC1355 NC Primary

Addresses

Primary practice location

1433 Emerywood Dr
Suite C
Charlotte, NC 28210-4105

Mailing address

1433 Emerywood Dr
Suite C
Charlotte, NC 28210-4105
Phone (704) 553-2020

Other identifiers 1

IdentifierTypeStateIssuer
890987AMedicaidNC

National Provider Directory

National Provider Directory

Locations

1433 Emerywood Dr
Ste C
Charlotte, NC 28210
Phone (704) 553-2020

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": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1336415579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 EMERYWOOD DR",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104105",
            "telephone_number": "704-553-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 EMERYWOOD DR",
            "address_2": "SUITE C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104105",
            "telephone_number": "704-553-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YVONNE T. SHOOK O.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "SHOOK",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "704-553-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890987A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.