David Scott Shettle, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2753 Issued in FL

Practice address

4200 4TH St N
Suite F
St Petersburg, FL 33703-4735

Phone

(727) 528-2015

Fax

(727) 528-2010

NPI assigned

Jul 28, 2005

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 FL

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

Specialty

Optometry

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

D Scott Shettle OD PAGroup PAC ID 8123178175, 2 clinicians

Practice addresses (Care Compare)

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.

• D Scott Shettle OD PA

  dba Shettle Family Eye Care & Eye Wear

  • Eyewear Supplier
  • St Petersburg, FL
  • NPI 1265674733
  Medicare reassignment Care Compare group NPD Authorized official
• Optometric Associates of Florida, P.a.

  dba InnoVision

  • Optometrist
  • Largo, FL
  • NPI 1346316676
  NPD (past)
• TB Eye Care PA

  dba InnoVision

  • Optometrist
  • Palm Harbor, FL
  • NPI 1902956030
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1740280130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 RIVERSIDE RIDGE RD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346888802",
            "telephone_number": "727-422-2940",
            "fax_number": "727-528-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 4TH ST N",
            "address_2": "SUITE F",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337034735",
            "telephone_number": "727-528-2015",
            "fax_number": "727-528-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTLE",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620051601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemary H Sherman, MD
• Shanna Ann Sherman, ARNP
• Theodore Roosevelt Sherman, M.D.
• Wayne D Sherman, D.O
• Pamela Diane Sherwin, LCSW
• Logan Scott Shettle, O.D.
• Hester Fay Shieh, MD
• Shifting Tides Therapy LMSW, PLLC
• Bonnie Shimel, ISW
• Sean Shipton, P.T.

• Optometrist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.