Shelley Williams, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2968 Issued in MO

Practice address

2200 Forum Blvd
102
Columbia, MO 65203-2700

Phone

(573) 445-8780

Fax

(573) 445-8782

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Southern College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Specialties of Missouri LLCGroup PAC ID 9931421187, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Eyecare Specialties of Missouri LLC

  • Optometrist
  • Warrensburg, MO
  • NPI 1730596248
  Medicare reassignment Care Compare group NPD
• Eyecare Specialties of Missouri LLC

  • Optometrist
  • Lees Summit, MO
  • NPI 1720453251
  NPD
• Eyecare Specialties of Missouri LLC

  • Optometrist
  • Sedalia, MO
  • NPI 1053482711
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1750384111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 LONGFELLOW LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031625",
            "telephone_number": "573-446-1139",
            "fax_number": "573-445-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORUM BLVD",
            "address_2": "102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032700",
            "telephone_number": "573-445-8780",
            "fax_number": "573-445-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHELLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "108696",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "000009118",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty D Williams, DDS
• Morgan Williams
• Rebecca Levy Williams, LMSW
• Scott Edward Williams, MSW
• Sharon Kay Williams
• Stephen Cory Williams
• Terence Terrell Williams
• Zion Williams
• Ethan Williamson, MD
• Harold A Williamson, MD

• Optometrist in Columbia, MO
• Providers in Columbia, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.