Individual provider Active NPI

Shannon Swayne, OD

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1396154522
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003260 Issued in CO
Practice address
1000 Wellington Ave
Ste a
Grand Junction, CO 81501-8180
Phone
(720) 524-1001
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003260 CO Primary
Optometrist 152W00000X 2830 OK

Addresses

Primary practice location

1000 Wellington Ave
Ste a
Grand Junction, CO 81501-8180

Mailing address

3900 E Mexico Ave
Ste 102
Denver, CO 80210-3940
Phone (720) 524-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140930001799 TX Practitioner - Optometry 9739309584 Reassigns benefits to 1 organization
I20161212000364 CO Practitioner - Optometry 9739309584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
2020 Eye Care PLLCGroup PAC ID 0345131181, 5 clinicians

Practice addresses (Care Compare)

3122 Blake Ave
Glenwood Springs, CO 81601-4415
Phone (970) 945-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Aug 4, 2014 Accepting new patients
2020 Eye Care PLLC Optometrist CurrentSince Sep 12, 2018 Accepting new patients
Cherokee Nation CurrentSince Aug 4, 2014 Accepting new patients
Cherokee Nation Current Accepting new patients
2020 Eye Care PLLC Optometrist Past Accepting new patients
Advantage Eyecare, P.C. Optometrist PastSince Jul 1, 2015 Accepting new patients

Locations

59 N 4th St
Carbondale, CO 81623
Phone (970) 963-3937

3122 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 945-2020

501 E 5th St
Bartlesville, OK 74003
Phone (918) 336-0823

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 7

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": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1396154522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE",
            "address_2": "STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103940",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WELLINGTON AVE",
            "address_2": "STE A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018180",
            "telephone_number": "720-524-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAYNE",
        "first_name": "SHANNON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003260",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.