Dr. Jerry L. Shue

Primary specialty

OptometristTaxonomy code 152W00000X

License

2174 Issued in AR

Legal business name

DR. JERRY L. SHUE

Practice address

406 W Pershing Blvd
N Little Rock, AR 72114-2146

Phone

(501) 753-3145

Fax

(501) 753-1806

NPI assigned

Oct 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Lester Shue, OD

Title

Owner

Phone

(501) 753-3145

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487735718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2100",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721152100",
            "telephone_number": "501-753-3145",
            "fax_number": "501-753-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W PERSHING BLVD",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721142146",
            "telephone_number": "501-753-3145",
            "fax_number": "501-753-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERRY L. SHUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LESTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-753-3145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D MERC",
            "identifier": "0176870001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in N Little Rock, AR
• Providers in N Little Rock, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.