Individual provider Active NPI

Lynn Curtis Shewmaker, O.D.

  • Optometrist
  • Ft Mitchell, KY
National Provider Identifier
1346204005
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0938DT Issued in KY
Practice address
2174 Dixie Hwy
Ft Mitchell, KY 41017-2902
Phone
(859) 341-2566
Fax
(859) 341-2568
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0938DT KY Primary

Addresses

Primary practice location

2174 Dixie Hwy
Ft Mitchell, KY 41017-2902

Mailing address

2174 Dixie Hwy
Ft Mitchell, KY 41017-2902
Phone (859) 341-2566

Other identifiers 2

IdentifierTypeStateIssuer
7100172260MedicaidKY
77009389MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1346204005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2174 DIXIE HWY",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410172902",
            "telephone_number": "859-341-2566",
            "fax_number": "859-341-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 DIXIE HWY",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410172902",
            "telephone_number": "859-341-2566",
            "fax_number": "859-341-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEWMAKER",
        "first_name": "LYNN",
        "middle_name": "CURTIS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0938DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100172260",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009389",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Mitchell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.