Organization Active NPI

Jeffrey D. Shearer, O.D., P.a

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1659494102
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2119 Issued in FL
Legal business name
JEFFREY D. SHEARER, O.D., P.A
Practice address
9978 Old Baymeadows Rd
Suite # 3
Jacksonville, FL 32256-7905
Phone
(904) 641-3937
Fax
(904) 641-0159
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Dr. Jeffrey D Shearer, O.D.NPI 1689717852
Title
Eye Doctor
Phone
(904) 641-3937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC2119 FL Primary

Addresses

Primary practice location

9978 Old Baymeadows Rd
Suite # 3
Jacksonville, FL 32256-7905

Mailing address

9978 Old Baymeadows Rd
Suite # 3
Jacksonville, FL 32256-7905
Phone (904) 641-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120529000310 FL Part B Supplier - Clinic/Group Practice 2264695386 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

9978 Old Baymeadows Rd
Ste 3
Jacksonville, FL 32256
Phone (904) 641-3937

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1659494102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9978 OLD BAYMEADOWS RD",
            "address_2": "SUITE # 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567905",
            "telephone_number": "904-641-3937",
            "fax_number": "904-641-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9978 OLD BAYMEADOWS RD",
            "address_2": "SUITE # 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567905",
            "telephone_number": "904-641-3937",
            "fax_number": "904-641-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY D. SHEARER, O.D., P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "SHEARER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EYE DOCTOR",
        "authorized_official_telephone_number": "904-641-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.