Individual provider Active NPI

Lynda Jean Shepard-Marziale, OD

  • Optometrist
  • Washington, NC
National Provider Identifier
1497783203
Registry record updated Aug 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1558 Issued in NC
Practice address
570 Pamlico PLZ
Washington, NC 27889-3337
Phone
(252) 329-7025
Fax
(252) 948-0309
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1558 NC Primary

Addresses

Primary practice location

570 Pamlico PLZ
Washington, NC 27889-3337

Mailing address

100 Providence Place
Chocowinity, NC 27817
Phone (828) 384-0377

Other identifiers 8

IdentifierTypeStateIssuer
0917POtherBLUE CROSS BLUE SHIELD NC
890917PMedicaidNC
2200131OtherUNITED HEALTHCARE
37485OtherVISION SERVICE PLAN
6952803OtherCIGNA
115086OtherDAVIS VISION
15667OtherSPECTERA VISION
25353OtherSUPERIOR VISION

Other names 1

  • Lynda Jean Shepard Professional name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060831000080 NC Practitioner - Optometry 0042214272 Practice locations: Greenville, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1558NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Better Image Optical Inc Past Accepting new patients
Family Vision LLC Optometrist PastSince Apr 2, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754179200000",
    "number": "1497783203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROVIDENCE PLACE",
            "city": "CHOCOWINITY",
            "state": "NC",
            "postal_code": "27817",
            "telephone_number": "828-384-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PAMLICO PLZ",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893337",
            "telephone_number": "252-329-7025",
            "fax_number": "252-948-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD-MARZIALE",
        "first_name": "LYNDA",
        "middle_name": "JEAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2025-08-03",
        "certification_date": "2025-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "0917P",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890917P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2200131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "37485",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6952803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "115086",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA VISION",
            "identifier": "15667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR VISION",
            "identifier": "25353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDA",
            "last_name": "SHEPARD",
            "middle_name": "JEAN",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.