William R. Shockley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T964 Issued in GA

Practice address

47 Jefferson St
Newnan, GA 30263-1948

Phone

(770) 254-0200

Fax

(770) 254-1281

NPI assigned

Mar 28, 2007

Sex

Male

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 GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Side Eye LLC

  dba Newnan Family Eyecare

  • Optometrist
  • Newnan, GA
  • NPI 1881224681
  Medicare reassignment NPD

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700905999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 JEFFERSON ST",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631948",
            "telephone_number": "770-254-0200",
            "fax_number": "770-254-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 JEFFERSON ST",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631948",
            "telephone_number": "770-254-0200",
            "fax_number": "770-254-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "T964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT",
            "identifier": "0786430001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatum Shepard, D.C.
• Deborah L Sheppard
• Sharon Diane Shields, D.C.
• Jeffrey David Shirley, CNS
• Alyssa Renee Shoch, HS DIPLOMA
• Savannah Shoemaker, APRN
• Ahmad Shqeirat
• Nathan Shuler II, OTR/L
• Leah Shupe, PAC
• Side Eye LLC (Newnan Family Eyecare)

• Optometrist in Newnan, GA
• Providers in Newnan, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.