Organization Active NPI

Donna L Shotwell OD PA

  • Optometrist
  • Sarasota, FL
National Provider Identifier
1427358365
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2389 Issued in FL
Legal business name
DONNA L SHOTWELL OD PA
Practice address
4934 Fruitville Rd
Sarasota, FL 34232-2206
Phone
(941) 371-7644
Fax
(941) 371-0244
NPI assigned
Oct 26, 2010
Last updated
Dec 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Dr. Donna L. ShotwellNPI 1881785970
Title
Owner
Phone
(941) 371-7644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2389 FL Primary

Addresses

Primary practice location

4934 Fruitville Rd
Sarasota, FL 34232-2206

Mailing address

4934 Fruitville Rd
Sarasota, FL 34232-2206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101228000232 FL Part B Supplier - Clinic/Group Practice 2961690425 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2212058Donna L Shotwell OD PA4934 Fruitville Rd, Sarasota, FL 34232Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory

Locations

4934 Fruitville Rd
Sarasota, FL 34232
Phone (941) 371-7644

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": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1427358365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4934 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322206",
            "telephone_number": "941-371-7644",
            "fax_number": "941-371-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA L SHOTWELL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "SHOTWELL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-371-7644",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.