Individual provider Active NPI

Shauna M Thornhill, O.D.

  • Optometrist
  • Amarillo, TX
National Provider Identifier
1629277942
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7077T Issued in TX
Practice address
3700 E Interstate 40
Amarillo, TX 79103
Phone
(806) 372-1977
Fax
(806) 342-3029
NPI assigned
Jul 16, 2007
Last updated
May 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7077T TX Primary

Addresses

Primary practice location

3700 E Interstate 40
Amarillo, TX 79103

Mailing address

4505 Aberdeen Dr
Amarillo, TX 79119-6429
Phone (806) 372-1977

Other practice location 1

4215 Canyon Dr
Amarillo, TX 79110-1105
Phone (806) 353-1977

Other identifiers 1

IdentifierTypeStateIssuer
01919748MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080229000583 TX Practitioner - Optometry 4789768615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3700 E Interstate 40
Amarillo, TX 79103-6127
Phone (806) 372-1977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7077TXMDChiropractor
7077TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley J. Anderson, O.D., P.C. Optometrist PastSince Jun 3, 2008 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1629277942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 ABERDEEN DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196429",
            "telephone_number": "806-372-1977",
            "fax_number": "806-342-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 E INTERSTATE 40",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79103",
            "telephone_number": "806-372-1977",
            "fax_number": "806-342-3029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4215 Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791101105",
            "country_code": "US",
            "telephone_number": "806-353-1977",
            "fax_number": "806-353-7357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNHILL",
        "first_name": "SHAUNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7077T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01919748",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.