Shayne M Sheridan OD

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SHAYNE M SHERIDAN OD

Practice address

3732 Creekshire CT
Winston Salem, NC 27103-1363

Phone

(336) 793-5904

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 2022By 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. Shayne M Sheridan, OD

Title

Owner

Phone

(336) 793-5904

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1659091429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 CREEKSHIRE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3732 CREEKSHIRE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031363",
            "telephone_number": "336-793-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAYNE M SHERIDAN OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "SHAYNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-793-5904",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Shaw, CRC, LCASA
• Patrice Lashay Shaw, PA
• William Frederick Shaw Jr., MD
• Hailey Shawron, RN
• Kasi Cox Shay, MSN CRNP
• David Sami Shbeeb, DO
• Samuel Shea, MD
• Christopher I Sheaffer, PH.D.
• Dale A Shealy, PT
• Ronald Bernard Shealy, MD

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.