Shaune Wallace, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

931 Issued in NV

Practice address

2210 Idaho St
Elko, NV 89801-2643

Phone

(775) 738-6727

NPI assigned

Sep 21, 2006

Sex

Male

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 NV

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 California College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SG Optical LLCGroup PAC ID 6204995954, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• SG Optical LLC

  • Optometrist
  • Elko, NV
  • NPI 1649485483
  Medicare reassignment Care Compare group
• B. Michael Southam, OD, PC

  • Optometrist
  • Reno, NV
  • NPI 1235550146
  Medicare reassignment NPD
• Pritchett Eye Care PC

  • Optometrist
  • Sparks, NV
  • NPI 1962717603
  Medicare reassignment
• Pritchett Eye Care PC

  • Optometrist
  • Reno, NV
  • NPI 1225343965
  NPD
• Pritchett Eye Care PC

  • Optometrist
  • Sparks, NV
  • NPI 1679889372
  NPD
• Pritchett Eye Care PC

  • Optometrist
  • Pahrump, NV
  • NPI 1730664327
  NPD
• B. Michael Southam, OD, PC

  • Optometrist
  • Winnemucca, NV
  • NPI 1912562596
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1467550335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 IDAHO ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012643",
            "telephone_number": "775-738-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 IDAHO ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012643",
            "telephone_number": "775-738-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHAUNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson C Waldron, DNP, APRN, FNP-BC
• Glen Neal Waldron, MSPT
• Walgreen Co
• Ashley Walker
• Celeste Marie Walkos, CNP
• Walmart Inc.
• Diana Waner
• Ward Hyperbarics
• Christopher H Ward, MD
• Dean Edward Ward, D.C,

• Optometrist in Elko, NV
• Providers in Elko, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.