Philip Leroy Shettle, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

OS 1590 Issued in FL

Practice address

670 Clearwater Largo Rd N
Suite a
Largo, FL 33770-2377

Phone

(727) 581-8755

Fax

(727) 581-8756

NPI assigned

Jul 12, 2005

Last updated

Aug 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Shettle Optical Solutions,Inc.

  • Eyewear Supplier
  • Largo, FL
  • NPI 1598972077
  Medicare reassignment NPD
• Philip L. Shettle D.O., P.a.

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1649356775
  Authorized official Same address or phone

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1427056548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 CLEARWATER LARGO RD N",
            "address_2": "SUITE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702377",
            "telephone_number": "727-581-8755",
            "fax_number": "727-581-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 CLEARWATER LARGO RD N",
            "address_2": "SUITE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702377",
            "telephone_number": "727-581-8755",
            "fax_number": "727-581-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTLE",
        "first_name": "PHILIP",
        "middle_name": "LEROY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS 1590",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "29764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046607700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "81475",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "185886390",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheridan Radiology Services of Pinellas, Inc. (Pinellas Radiology Associates)
• Christopher Michael Sherman, M.D.
• Robert James Shermeta, DPM
• Shettle Optical Solutions,Inc.
• Philip Lee Shettle, D.O.
• Todd Alan Shettle, O.D.
• Kedar R. Shetye, M.D.
• Paul Daniel Shimkonis, PTA
• Kathleen Demolli Shirley, PT,OCS,GCS
• Annie Shockley, PHARMD

• Ophthalmology Physician in Largo, FL
• Providers in Largo, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.