Individual provider Active NPI

Steven R. Shum, O.D.

  • Corneal and Contact Management Optometrist
  • Germantown, TN
National Provider Identifier
1710991872
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
547 Issued in TN
Practice address
2109 West St
Suite 1
Germantown, TN 38138-3837
Phone
(901) 754-6020
Fax
(901) 754-9882
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 547 TN Primary

Addresses

Primary practice location

2109 West St
Suite 1
Germantown, TN 38138-3837

Mailing address

2109 West St
Suite 1
Germantown, TN 38138-3837
Phone (901) 754-6020

Other identifiers 4

IdentifierTypeStateIssuer
2240152OtherTNUHC
0159021OtherTNBCBS OF TN PROVIDER ID
410010020OtherTNMEDICARE RR
6172558OtherTNCIGNA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090312000340 TN Practitioner - Optometry 8729144936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Sioux City College of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optical Boutique Family EyecareGroup PAC ID 0143670414, 3 clinicians

Practice addresses (Care Compare)

2109 W St
Suite 1
Germantown, TN 38138-3834
Phone (901) 754-6020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
547TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven R. Shum Corneal and Contact Management CurrentSince May 1, 2017 Accepting new patients
Optical Boutique Family Eyecare CurrentSince Jan 15, 2024 Accepting new patients

Locations

2109 West St
Ste 1
Germantown, TN 38138
Phone (901) 754-6020

2109 West St
Germantown, TN 38138
Phone (901) 754-6020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1710991872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 WEST ST",
            "address_2": "SUITE 1",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383837",
            "telephone_number": "901-754-6020",
            "fax_number": "901-754-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 WEST ST",
            "address_2": "SUITE 1",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383837",
            "telephone_number": "901-754-6020",
            "fax_number": "901-754-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUM",
        "first_name": "STEVEN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2240152",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN PROVIDER ID",
            "identifier": "0159021",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "410010020",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6172558",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.