Derrall Shawn Parker, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD116562 Issued in MO

Practice address

360 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920

Phone

(573) 335-3577

Fax

(573) 335-1559

NPI assigned

Feb 16, 2006

Last updated

Jul 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 13

Other names 1

• Dr. D. Shawn Parker Professional name

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Louisville School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Specialists LLCGroup PAC ID 0143117028, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183
• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sparker@ecs.direct.eyemdemr.com

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.

• Eye Care Specialists, LLC

  • Ophthalmology Physician
  • Cape Girardeau, MO
  • NPI 1316071780

  IL

  Medicare reassignment Care Compare group
• Doctors Park Surgery Inc

  • Ambulatory Surgical Clinic/Center
  • Cape Girardeau, MO
  • NPI 1861487324
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Medical Center

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1467412726
  Care Compare affiliation
• Saint Francis Medical Center

  • Internal Medicine Physician
  • Cape Girardeau, MO
  • NPI 1578513016

  Hospital

  Care Compare affiliation
• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1700850500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-335-3577",
            "fax_number": "573-335-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034920",
            "telephone_number": "573-335-3577",
            "fax_number": "573-335-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "DERRALL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "KY30522",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "MD116562",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "036-101500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA 61.1257991",
            "identifier": "5971604",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE 43.1804777",
            "identifier": "P00288000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS TAX ID 61.1257991",
            "identifier": "000000112968",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE 43.1804777",
            "identifier": "180035389",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE 61.1257991",
            "identifier": "180042674",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH 43.1804777",
            "identifier": "1238355",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS MO 43.1804777",
            "identifier": "115309",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE 43.1804777",
            "identifier": "180035388",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64012115",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK 43.1804777",
            "identifier": "393192",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK 61.1257991",
            "identifier": "393192",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUEGRASS FAM 61.1257991",
            "identifier": "G48960",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205249600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D. SHAWN",
            "last_name": "PARKER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lori Alyse Palmer, LBSW
• Charles H Pancoast, MD
• Park Pharmacy, LLC
• Frederic C Park III, MD
• Kee Bum Park, MD
• Linda Parker
• Scott Andrew Parker, MS, ATC
• Sylvester Parker, DDS
• Parkviewrx Missouri, LLC (BroadwayRx)
• Faith Elizabeth Parr

• Ophthalmology Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.