Organization Active NPI

North Shore Eye Care, P.a.

  • Optometrist
  • Lago Vista, TX
National Provider Identifier
1487803961
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6895TG Issued in TX
Legal business name
NORTH SHORE EYE CARE, P.A.
Practice address
7708 Lohmans Ford Rd
BLDG., B, Suite 102
Lago Vista, TX 78645-4781
Phone
(512) 267-7700
NPI assigned
Sep 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Dr. Shannon Cherie Kerns, O.D.NPI 1295748663
Title
Optometrist/President
Phone
(512) 364-7932

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6895TG TX Primary

Addresses

Primary practice location

7708 Lohmans Ford Rd
BLDG., B, Suite 102
Lago Vista, TX 78645-4781

Mailing address

7708 Lohmans Ford Rd
BLDG., a, Suite 102
Lago Vista, TX 78645-4781
Phone (512) 267-7700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081222000099 TX Part B Supplier - Clinic/Group Practice 4688736903 Receives reassigned benefits from 3 practitioners
Practice locations: Lago Vista, TX

National Provider Directory

National Provider Directory

Locations

7708 Lohmans Ford Rd
#B102N
Lago Vista, TX 78645
Phone (512) 267-7700

7708 Lohmans Ford Rd
Ste 102A
Lago Vista, TX 78645

7708 Lohmans Ford Rd
Ste 102B
Lago Vista, TX 78645
Phone (512) 267-7700

7708 Lohmans Ford Rd
Ste 102
Lago Vista, TX 78645
Phone (512) 267-7700

7708 Lohmans Ford Rd
Lago Vista, TX 78645

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1487803961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7708 LOHMANS FORD RD",
            "address_2": "BLDG., A, SUITE 102",
            "city": "LAGO VISTA",
            "state": "TX",
            "postal_code": "786454781",
            "telephone_number": "512-267-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7708 LOHMANS FORD RD",
            "address_2": "BLDG., B, SUITE 102",
            "city": "LAGO VISTA",
            "state": "TX",
            "postal_code": "786454781",
            "telephone_number": "512-267-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE EYE CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "KERNS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "CHERIE",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "512-364-7932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6895TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lago Vista, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.