Diana Shekoury, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003677 Issued in GA

Practice address

1075 Bandy Pkwy Ste 110
Locust Grove, GA 30248-7036

Phone

(770) 228-3836

NPI assigned

Jul 11, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Optometry

Education

Southern College of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leiv M Takle MD PCGroup PAC ID 2062400286, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: diana.shekouryod.p1@direct.teg.nextgenshare.com

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.

• Leiv M Takle MD PC

  • Ophthalmology Physician
  • Griffin, GA
  • NPI 1568665404

  Optometrist

  Medicare reassignment Care Compare group NPD
• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  NPD (past)
• Takle Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Locust Grove, GA
  • NPI 1740776517
  NPD (past)

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

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1346131091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BANDY PKWY STE 110",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BANDY PKWY STE 110",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487036",
            "telephone_number": "770-228-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKOURY",
        "first_name": "DIANA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modupe Oluyemisi Salami, FNP
• Chaunta Wade Shannon
• Chetan Sharma, M.D.
• Khani J Shaw
• Annie Felecia Sheets
• Shield Care Transport LLC
• Jamie Shuler
• Sharon Gail Singley
• Sitm Transportation
• Smile Parlor LLC

• Optometrist in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.