Kathy Lynn Shamblin, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

TN1074 Issued in TN

Practice address

915 Colloredo Blvd
Shelbyville, TN 37160-2780

Phone

(931) 684-2197

Fax

(931) 684-8562

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Southern College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bedford Vision and Eye Clinic PLLCGroup PAC ID 8527318385, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aundrea Kay Henderson Gregory, O.D.

  • Optometrist
  • Shelbyville, TN
  • NPI 1568746816
  Medicare reassignment

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.

• Bedford Vision and Eye Clinic PLLC

  • Optometrist
  • Shelbyville, TN
  • NPI 1992217756
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1649286576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602780",
            "telephone_number": "931-684-2197",
            "fax_number": "931-684-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 COLLOREDO BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602780",
            "telephone_number": "931-684-2197",
            "fax_number": "931-684-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "TN1074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3596029",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Nathan Sarapin, P.A.
• Rhonda Saylor, M.A.
• Jordan L Schlabach, DPT
• Samuel Paul Sells Jr., MD
• Seven Springs Orthopaedics, PC
• Sharon Stocking MD PC
• Mary Leta Shavers
• Shelbyville Bedford County Senior Citizens Center
• Shelbyville Cardiology, LLC
• Shelbyville Center for Nursing and Rehabilitation LLC

• Vision Therapy Optometrist in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Vision Therapy Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.