Eye Shop PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1706 Issued in AZ

Legal business name

EYE SHOP PLLC

Practice address

21321 E Ocotillo Rd Ste 105
Queen Creek, AZ 85142-5993

Phone

(480) 656-7739

Fax

(480) 656-1637

NPI assigned

Oct 28, 2014

Last updated

Jun 7, 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. Jared A Shaver, ODNPI 1316178973

Title

Sole Member

Phone

(480) 656-7739

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

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.

• Eric Bradford Vanausdal, OD

  • Optometrist
  • Queen Creek, AZ
  • NPI 1255826681
  Medicare reassignment
• Alma D. Yamamoto, O.D.

  • Optometrist
  • Gilbert, AZ
  • NPI 1053624650
  Medicare reassignment
• Jared Allen Shaver, O.D.

  • Optometrist
  • Queen Creek, AZ
  • NPI 1316178973
  Authorized official Same address or phone

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591488000000",
    "number": "1538564984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425993",
            "telephone_number": "480-656-7739",
            "fax_number": "480-656-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425993",
            "telephone_number": "480-656-7739",
            "fax_number": "480-656-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SHOP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "480-656-7739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esi Therapy, PC
• Robert Etherington
• Ev Pain Solutions, LLC
• Laurie J Evans, NP-C
• Mary Kay Ewald, OTR/L
• Eyes on Queen Creek PLLC (Eyes on Queen Creek)
• F7 Medical LLC (OneLife Medical Center)
• F7Medical (OneLife Medical Center)
• Christine Fahmy, OD
• Remon Fam

• Optometrist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.