Donald T Shute, OPTOMETRIC DOCTOR

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001620 Issued in WA

Practice address

1211 S 40TH Ave
Yakima, WA 98908-3961

Phone

(509) 966-2966

Fax

(509) 966-3230

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1730132614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083961",
            "telephone_number": "509-966-2966",
            "fax_number": "509-966-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083961",
            "telephone_number": "509-966-2966",
            "fax_number": "509-966-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "DONALD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIC DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001620",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1730D",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "SH2222",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001345",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Hailey Shuel
• Michael Severin Shultis, PA-C
• John P Shumaker, CP60027727
• Evan Thomas Shute, DPT
• Stephania Siclait, RN-BSN
• Faisal Rab Siddiqui, M.D.
• Cristina Sideris, MSW
• Laurie Siebler, M.A.

• Optometrist in Yakima, WA
• Providers in Yakima, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.