NPIMap

Organization Active NPI

Dana L. Shepard, O.D. and Associates

  • Optometrist
  • Waterbury, CT
National Provider Identifier
1538339262
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2198 Issued in CT
Legal business name
DANA L. SHEPARD, O.D. AND ASSOCIATES
Practice address
3600 E Main St
Waterbury, CT 06705-3851
Phone
(203) 596-0406
Fax
(203) 756-7316
NPI assigned
Mar 10, 2008
Reactivated
Oct 15, 2008
Last updated
Oct 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Dana Shepard, O.D.NPI 1003927856
Title
Optometrist
Phone
(203) 596-0406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2198 CT Primary

Addresses

Primary practice location

3600 E Main St
Waterbury, CT 06705-3851

Mailing address

3600 E Main St
Waterbury, CT 06705
Phone (203) 596-0406

National Provider Directory

National Provider Directory

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": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1538339262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "203-596-0406",
            "fax_number": "203-756-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067053851",
            "telephone_number": "203-596-0406",
            "fax_number": "203-756-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA L. SHEPARD, O.D. AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-10-15",
        "deactivation_date": "2008-10-07",
        "reactivation_date": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "203-596-0406",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.