Shannon Elwood, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1201 Issued in NE

Practice address

8013 N 164TH St
Bennington, NE 68007-5569

Phone

(402) 203-8885

NPI assigned

Jan 22, 2007

Last updated

May 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Definitive Vision LLCGroup PAC ID 4880870666, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Definitive Vision LLC

  • Optometrist
  • Omaha, NE
  • NPI 1215231717
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1568516342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 FARNAM ST",
            "address_2": "STE 7103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681313569",
            "telephone_number": "402-502-7323",
            "fax_number": "402-502-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 N 164TH ST",
            "city": "BENNINGTON",
            "state": "NE",
            "postal_code": "680075569",
            "telephone_number": "402-203-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELWOOD",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Folly Pierre Ekoue
• Bahra Elamin
• Eli & Eton Home Care
• Elite Foot and Ankle Specialists
• Leigh Jean Elwood, RN
• Emily Wiemers Therapy, LLC
• Lily Engeman
• Fadi LLC (Fadi Medical Transportation)
• Kelsee Fargo
• Ferguson Health Care Inc (Bennington Chiropractic)

• Optometrist in Bennington, NE
• Providers in Bennington, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.